POLICY STATE TECHNICAL ASSISTANCE TEAM MANUAL

Transcription

1 POLICY STATE TECHNICAL ASSISTANCE TEAM MANUAL NATIONAL ASSOCIATION OF CHRONIC DISEASE DIRECTORS

2 NACDD DIABETES COUNCIL The National Association of Chronic Disease Directors (NACDD) is a national public health association, founded in 1988 to link the chronic disease program directors of each state and U.S. territory to provide a national forum for chronic disease prevention and control efforts. Since its founding, NACDD has made impressive strides in mobilizing national efforts to reduce chronic diseases and the associated risk factors. The NACDD Diabetes Council represents Diabetes Prevention and Control Program (DPCPs) staff in the states, U.S. territories, and the District of Columbia as well as those who care about improving the health of people affected by diabetes. The Diabetes Council is a resource for DPCP staff for building infrastructure, learning best practices, collecting data and evaluating the effectiveness of their activities. The core purpose of the Diabetes Council is to help every DPCP achieve its mission, through influencing attitudes and decisions, making connections and building capacity. To realize this purpose, three strategic priorities form the bedrock of the Council s Strategic Plan: Attract and develop public health leaders; Define and support DPCPs in new arenas; and Speak with one voice as a proactive advocate for DPCPs. These priorities incorporate elements of the chronic disease competencies, and the Ten Essential Health Services, and fully support the Diabetes Council vision of being widely viewed as the go to resource for DPCPs, and an influential advocate for the needs and priorities of DPCPs. The NACDD Diabetes Council Advocacy Committee informs Council members about legislative and policy issues related to diabetes prevention and control, and provides increased access to the tools and technical assistance needed to build advocacy capacity among DPCPs. The Policy State Technical Assistance Team (PSTAT) Program was developed by a subcommittee of the Advocacy Committee. Led by Natasha McCoy (Louisiana), the original subcommittee members included: Jim Copeland (District of Columbia), Ann Forburger (Virginia), Karin Omark (California), and Brenda Ralls (Utah). For more information about the NACDD, or the NACDD Diabetes Council, please contact the NACDD at the following address, or visit the NACDD website at National Association of Chronic Disease Directors 2872 Woodcock Blvd., Suite 220 Atlanta, GA Phone: (770) / Fax: (770) Diabetes Council: Marti Macchi Voice: (785) MMacchi@chronicdisease.org 2

3 ACKNOWLEDGEMENT The NACDD Diabetes Council PSTAT Program is supported by Cooperative Agreement U58DP from the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC. The Diabetes Council wishes to thank the NACDD State Technical Assistance and Review Program (STAR), the State and Territorial Injury Prevention Directors STAT Program, and the Association of State and Territorial Dental Directors State Oral Health Program Review. The PSTAT subcommittee reviewed and adapted some of their program materials in developing this program. 3

4 TABLE OF CONTENTS Section Page Number PSTAT Overview 5 PSTAT Purpose, Goals and Identification of Technical Assistance Needs 6 Steps of the PSTAT Process 8 DPCP Key Responsibilities 9 PSTAT Visit Request 10 Request Review and Selection 13 Initial Planning 14 DPCP PSTAT Briefing Book 15 PSTAT Visit Logistics 16 PSTAT Visit 17 PSTAT Evaluation and Follow-Up 18 Advocacy Overview 19 List of Appendices Appendix A PSTAT Process Chart 22 Appendix B PSTAT Request Checklist 23 Appendix C Letter of Intent Form Instructions 24 Appendix D Background Instructions and Form 26 Appendix E Site Visit Dates 27 Appendix F Readiness Assessment 28 Appendix G Briefing Book 29 Appendix H Team Orientation Conference Calls 31 Appendix I Suggested Site Visit Agenda 33 Appendix J Debriefing Form 35 Appendix K Advocacy Resources 36 References 37 4

5 PSTAT OVERVIEW Stakeholder education in policy development is becoming an increasingly important aspect of Diabetes Prevention and Control Program (DPCP) activity. Data collected by the 2007 Diabetes Council Professional Development Survey indicated that DPCPs would benefit from training, tools and resources to become more effective in this area. Education of legislators and other stakeholders, and working with external partners to advocate for the needs of people with or at risk for diabetes fall within the scope of allowed DPCP activity. DPCP efforts should be designed to achieve maximum reach and impact in high risk populations, and should focus on influencing change at a systems level, as opposed to attempting to reach or impact individuals directly. As identified in the ten Essential Public Health Services, public health managers and staff can: identify and coordinate roles of partners; collect/analyze data (e.g. develop reports/fact sheets); serve as a scientific resource to policy makers, business leaders, health practitioners, and the media; lead health education campaigns and mobilize local health departments, and; serve as a representative of the state, U.S. territory or District of Columbia health department to assure development and implementation of policies that protect the health of the public. Yet, individuals working in the DPCP may not have the skills or resources to educate and engage stakeholders in policy development. As a result, they are often uncomfortable and/or less effective in engaging key stakeholders. Building support for public health requires the application of information and resources to affect systemic changes that shape the way people live in a community. Information, skills and resources are necessary to develop and implement policies that will reduce the occurrence or severity of public health problems. To increase advocacy capacity among DPCPs, the Diabetes Council has developed a three-pronged approach to provide necessary technical assistance and consultation to increase DPCP capacity to effectively fulfill their role in educating stakeholders. The three approaches include: (1) Annual Diabetes Conference training (either pre-conference training or conference workshop); (2) Policy State Technical Assistance Team (PSTAT) program; and (3) developing State Success Stories. PSTAT is a new and innovative approach for advocacy training provided by the Diabetes Council. A key component of the PSTAT program is the provision of technical assistance from a PSTAT Consultant team. This team will consist of one policy/advocacy expert, the American Diabetes Association regional advocacy director, the DPCP s CDC Project Officer or designee, and the NACDD Senior Diabetes Consultant. The PSTAT consultant team will guide the selected DPCPs and their partners to develop and implement an issue-specific advocacy plan and related tools, documents and technical resources. The program is meant to be an actionoriented, problem-solving endeavor. In 2010, the Diabetes Council pilot tested the PSTAT program in two DPCPs in need of technical assistance to address an emerging diabetes-related policy issue. Ultimately, the Diabetes Council will provide continual support to DPCPs for immediate, emerging and general capacitybuilding needs (see page 7). 5

6 PSTAT PURPOSE, GOALS/OBJECTIVES, AND IDENTIFICATION OF TECHNICAL ASSISTANCE NEEDS Purpose of the PSTAT Program To provide Diabetes Prevention and Control Programs (DPCPs) with technical assistance and training to address emerging policy issues. PSTAT Program Goal To increase a DPCP s capacity to engage and inform stakeholders, and effectively apply information and resources to impact policy changes that may reduce the burden of diabetes in its jurisdiction. PSTAT Program Objectives The PSTAT consultant team will assist the DPCP in achieving the objectives listed below. PSTAT will provide technical assistance focused on the emerging policy issue identified by the DPCP. Therefore, all developed products, tools and final advocacy plan will be related to the specified policy issue. It is anticipated that the DPCP will use the technical assistance recommendations to implement an appropriate policy response. A formative and impact evaluation will be conducted to determine effectiveness and impact of the PSTAT technical assistance process. Objective 1: Engage stakeholders DPCPs will identify and engage a diverse group of stakeholders to appropriately address a specific diabetes-related policy issue. Objective 2: Help with policy assessment DPCPs will conduct a policy assessment to determine the full impact of the proposed or pending diabetes-related policy or legislation. Objective 3: Develop advocacy plan with timeline to address the diabetes-related policy issue DPCPs will develop an advocacy plan based on recommendations from the PSTAT consultant team. Objective 4: Develop tools, products and resources DPCPs will develop at least one new or adapt at least one existing tool, product or resource to address the diabetes-related policy issue. Objective 5: Implement advocacy plan DPCPs will implement an advocacy plan strategy within three months of the PSTAT visit. Objective 6: Evaluate impact DPCPs will evaluate the implementation and impact of the advocacy plan. 6

7 Identification of Technical Assistance Needs CAPACITY BUILDING EMERGING IMMEDIATE Capacity Building = PSTAT will provide technical assistance to build the DPCP s capacity to engage stakeholders in developing effective policies and implementing and evaluating appropriate advocacy activities to address policy issues. The focus will be on general capacity building; not a single policy issue. For example, a state DPCP may seek assistance in building capacity within the diabetes council to develop and implement an advocacy plan or prepare for next year s budget review to seek additional funding for diabetes prevention and control. Capacity building is offered through the Advocacy Committee s advocacy training. Advocacy resources are also available online at: Emerging/Issue-specific = PSTAT will provide technical assistance to address a policy that is either: 1) in development, 2) proposed but not formally introduced or 3) formally introduced. An emerging issue is an issue that could be addressed no sooner than three months but no longer than a year. An example of an emerging issue is advocacy assistance sought to address a bill mandating health plans to cover diabetes education that has been introduced and is expected to be voted upon within six months. Immediate = Immediate technical assistance is assistance needed to address a policy issue that must be addressed in less than three months. For example, the legislature is in session and a response to a diabetesrelated bill is required within two weeks. Note: Due to limited resources, PSTAT is unable to provide technical assistance for immediate and capacity building issues at this time. However, if your DPCP has an immediate issue, please feel free to contact the PSTAT Consultant who may be able to direct you to other resources. If you have any questions about PSTAT or would like additional information, please contact Marti Macchi, NACDD Senior Diabetes Council and PSTAT Consultant. PSTAT Consultant Marti Macchi, MEd, MPH NACDD Senior Diabetes Consultant Phone: (785) MMacchi@chronicdisease.org 7

8 STEPS OF THE PSTAT PROCESS The NACDD Diabetes Council PSTAT program was developed to provide DPCPs with technical assistance and training to address emerging policy issues. The PSTAT process consists of eight main components to ensure consistency in program implementation and evaluation. A diagram of the PSTAT process is provided below. A more detailed process chart is provided in Appendix A. 8

9 DPCP Key Responsibilities Preparation and follow through of the DPCP is an important component of the PSTAT process and essential to the success of the PSTAT visit. Consequently, it is recommended that preparatory work begin at least 3 months prior to a desired visit. The following table provides an overall summary and timeline for the DPCP key responsibilities to assist with the planning, implementation, and follow-up for the PSTAT visit. Specific information on each responsibility is detailed throughout this manual. Responsibility Identify need for advocacy technical assistance related to an emerging policy. Review the PSTAT manual to assure PSTAT will meet technical assistance need. Discuss PSTAT with senior Department official (see Appendix C) to assure that a PSTAT visit will comply with department policies related to advocacy. Submit a PSTAT Site Visit Request. Discuss PSTAT request via conference call with PSTAT subcommittee and the PSTAT Consultant. Invite stakeholders and other key individuals to serve as members of the DPCP team and participate in the PSTAT visit. Identify DPCP lead for the DPCP team. Confirm PSTAT visit date. Timeline At least 3 months prior to visit At least 3 months prior to visit At least 3 months prior to visit 2 ½ months prior to visit 2 ½ months prior to visit 2 months prior to visit Prepare DPCP briefing book. 6 weeks prior to visit Assist PSTAT consultant in identifying hotel for PSTAT consultants and addressing other transportation and logistical needs. Identify and reserve meeting room for PSTAT visit. 6 weeks prior to visit 4 weeks prior to visit Participate in conference calls with PSTAT consultant team and finalize PSTAT visit agenda. 2-3 weeks prior to visit Participate in PSTAT visit and assist PSTAT consultant team with onsite logistical needs. During visit Complete evaluation tools. During visit Complete follow-up evaluation tools, including post-visit PSTAT Readiness Assessment. As specified Send thank you letters to DPCP team and other key participants. 1-2 weeks after visit Coordinate ongoing implementation of advocacy plan with DPCP partners. Work with NACDD Consultant to develop success story As specified in advocacy plan As specified 9

10 PSTAT Visit Request PSTAT is a technical assistance and training program for DPCPs that would like to become more effective in addressing emerging policy issues. At this time, technical assistance is provided in the form of a 1 ½ day site visit structured to help DPCPs engage stakeholders and develop an advocacy plan for a policy issue identified by the DPCP and its stakeholders. During the site visit, the DPCP and targeted stakeholders will meet with the PSTAT team for 1 ½ days and receive technical assistance and training from a team of content and subject matter experts, as well as individuals with DPCP experience (PSTAT consultant team). Example Legislation mandating health plan coverage for diabetes self-management education (DSME) among all statelicensed insurers will expire in 12 months. The legislature meets in six months and it is not known if the legislation will be extended. This is the last legislative session before the mandate expires. The PSTAT visit will focus on helping the DPCP engage stakeholders to collectively develop and implement an advocacy plan based on the DSME policy issue. The PSTAT consultant team will consist of advocacy content and subject matter experts and the DPCP s American Diabetes Association regional representative. PSTAT visit requests are accepted year-round and will be fulfilled on a first-come, first-served basis. Each request will be reviewed to determine appropriateness of the policy issue to the PSTAT process, readiness to address the policy issue, and availability of program resources. Currently, PSTAT is funded by a cooperative agreement granted to the National Association of Chronic Disease Directors from the Centers for Disease Control and Prevention (Division of Diabetes Translation). Due to limited resources, the number of site visits conducted each fiscal year (Oct. 1 Sept. 30) will depend upon the availability of funds through this cooperative agreement. There is no direct financial cost to the DPCP for PSTAT assistance. DPCPs interested in receiving technical assistance from PSTAT should do the following: 1. Review the PSTAT DPCP Manual The PSTAT DPCP Manual was created to help DPCPs 1) understand the PSTAT process, 2) determine if a PSTAT visit is appropriate for the identified policy issue and 3) outline the steps needed to apply, prepare, conduct and evaluate a PSTAT visit. It is recommended that DPCPs read the manual in its entirety and submit a request according to the steps outlined in this document. 2. Determine type of technical assistance needed At this time, PSTAT can only provide technical assistance for emerging policy issues. DPCPs should refer to the section Identification of Technical Assistance Needs on Page 7 to determine if assistance is requested for an emerging, capacity building or immediate policy issue. 10

11 3. Submit a PSTAT Visit Request Once the DPCP has identified the emerging policy issue and determined that it does not have the internal capacity to address it, the DPCP should complete a PSTAT Request and submit to the PSTAT consultant for consideration. The PSTAT Request will provide the PSTAT consultant and subcommittee with details about the nature and history of the policy issue. The PSTAT Request should be submitted at least three months before any critical policy-related deadline. PSTAT Request Components Letter of Intent Form DPCPs must complete the PSTAT Letter of Intent (Appendix C) and submit it to the PSTAT consultant with all required PSTAT request documents. Please provide the official title of the DPCP, date in which the Letter of Intent was completed and contact information for a primary and secondary contact person. The primary contact person must be a representative of the DPCP seeking the PSTAT request. The secondary contact can be another DPCP staff member or an official that directly supervises the highest official in the DPCP. A designated representative must maintain active communication with the PSTAT consultant, subcommittee and PSTAT consultant team throughout the PSTAT process. Consent from Authorized Official Having the support of a higher level official can significantly contribute to the success of the PSTAT process and subsequent advocacy activities. A higher level official is defined as a senior Department official who is organizationally above the most senior person in the Diabetes Prevention and Control Program. This person can be the Chronic Disease Director, Bureau Director or the State, Territory, or DC Health Official or their designee. The DPCP s PSTAT Request will not be reviewed if the Letter of Intent does not contain the signature of an authorized official. PSTAT Background Form The PSTAT Background Form (Appendix D) provides the PSTAT subcommittee with detailed information on the history and context of the policy issue, what efforts are taking place and to understand what the DPCP expects to obtain from the PSTAT visit. DPCPs are asked to provide as much detail as possible but remain within the three page limit. The information provided in the background form will also be used to help the PSTAT subcommittee select the PSTAT consultant team and to determine what technical assistance support will be provided during the site visit. 11

12 Site Visit Dates Please use the PSTAT Site Visit Dates document (Appendix E) to select up to three options for the 1½ day site visit. The site visit must be conducted over 1½ consecutive work days. DPCPs must choose dates that work best for program staff and targeted stakeholders. DPCP Organizational Chart Please include a copy of the DPCP s most recent organizational chart. Be sure to include information on the amount of time each DPCP staff person dedicates to the program (i.e. 1.0 FTE, 0.5 FTE, etc.). The organizational chart can also show which DPCP staff provide oversight or support functions to other programs. Health Department Organizational Chart Please provide a copy of the organizational chart for the health department. Indicate either directly on the organizational chart or in writing where the DPCP sits within the agency. Readiness Assessment Please submit all PSTAT request documents at the same time to ensure timely review and response. PSTAT Requests must be submitted electronically to Marti Macchi, Senior Diabetes Council Consultant, by at MMacchi@chronicdisease.org or fax at (785) For submission, please put the words PSTAT Request for (State/Territory/District of Columbia) DPCP (i.e. PSTAT Request for Anystate DPCP) in the subject line. PSTAT Requests should be submitted at least three months before any critical policy-related deadline. 4. Health Department Advocacy Policy If the DPCP receives approval for a PSTAT visit, the DPCP will be asked to provide a copy of the health department s advocacy policy or to inform the PSTAT consultant team of the absence of this document. This document is not required for the PSTAT Request but will be requested for inclusion in the DPCP briefing book. DPCPs submitting a PSTAT Request are asked to indicate on the PSTAT Request Checklist (Appendix B) whether or not initial contact has been made to acquire this document if the DPCP does not already have a copy of the policy. 12

13 Request Review and Selection The PSTAT approval process has two steps. First, the Diabetes Council Advocacy Committee s PSTAT subcommittee will review the DPCP s request and make a determination as to whether additional consideration is warranted. Next, if the DPCP s request is deemed adequate, the PSTAT subcommittee may meet with the DPCP via a conference call to clarify the policy issue and needs. The PSTAT subcommittee will use this information to approve or decline the DPCP s request. The PSTAT consultant will notify the DPCP of the final decision. The PSTAT subcommittee will work to ensure that all requests are reviewed and follow-up notification is provided in an appropriate, timely and effective manner. PSTAT Request Review Process PSTAT request received by Diabetes Council PSTAT consultant PSTAT consultant provides PSTAT request to the PSTAT subcommittee PSTAT subcommittee reviews request PSTAT subcommittee determines if request is appropriate for a PSTAT visit No - Refer DPCP to other resources Yes - Conduct conference call with DPCP for further clarification if needed PSTAT subcommittee reconvenes to determine if DPCP should receive PSTAT visit No - PSTAT consultant notifies DPCP of PSTAT request denial with explanation and referral to other resources Yes - PSTAT consultant notifies DPCP of PSTAT request approval 13

14 INITIAL PLANNING The NACDD PSTAT consultant, the PSTAT consultant team lead and the DPCP will collaboratively prepare for the PSTAT visit. The DPCP is also responsible for providing the NACDD PSTAT consultant with all documentation for the DPCP briefing book, which further describes the policy issue and context. A conference call will be held to clarify key issues and prepare travel and meeting logistics. The DPCP is also asked to assist in the development of the site visit agenda, identifying staff and internal and external partners to participate in the site visit, and supplying meeting space and office supplies. DPCP Briefing Book The PSTAT Briefing Book is a compilation of all documents provided by the DPCP and items developed or acquired throughout the PSTAT process to provide essential information to the PSTAT consultant team. Please refer to the section DPCP PSTAT Briefing Book (Page 15) for further information. Site Visit Agenda The PSTAT consultant will draft a site visit agenda following discussion with the DPCP on the policy issue and anticipated outcomes. A sample PSTAT visit agenda is provided in Appendix I. DPCP Conference Call The PSTAT consultant team lead is responsible for facilitating a conference call with the DPCP to finalize the site visit agenda and determine if any additional tools or resources are needed to address the DPCP s capacity needs. The DPCP is required to participate in this call, which will take place approximately two to three weeks prior to the PSTAT visit. The conference call can also be used to help the DPCP identify staff and ideal internal and external partners for the DPCP team; or to discuss persons identified for the DPCP team if already determined prior to the conference call. A second conference call will be scheduled one week prior to the visit addressing the CDC Policy Definition and DDT Perspective and Developing an Advocacy Plan. DPCP Team The DPCP will be asked to develop a DPCP team of individuals directly responsible for implementing the advocacy plan or providing technical support to the DPCP after the PSTAT visit. The DPCP team may consist of DPCP staff, the Chronic Disease Director or other key health department administrators, internal and external partners and stakeholders, and any other invited guests. DPCPs should use this time to recruit members for the DPCP team. The PSTAT consultant team can assist the DPCP in identifying ideal internal and external stakeholders for the DPCP team. The DPCP should check to see if the selected DPCP team members are available to participate in the entire 1½ day PSTAT visit 14

15 DPCP PSTAT BRIEFING BOOK The PSTAT Briefing Book is a compilation of all documents provided by the DPCP and items developed or acquired throughout the PSTAT process to provide essential information to the PSTAT consultant team. The PSTAT Briefing Book consists of the DPCP s PSTAT request documents, additional documents acquired from the DPCP, conference call notes and any reference items. PSTAT Briefing Book Contents: - PSTAT Letter of Intent - Selected site visit dates - Background form - Readiness Assessment (compiled results from pre-visit assessment) - DPCP organizational chart - Health department organizational chart - Health department advocacy policy - Conference call notes from the DPCP and PSTAT subcommittee call - Conference call notes from the DPCP and PSTAT consultant team call - PSTAT consultant team technical assistance notes - Reference documents for PSTAT visit The DPCP must submit any remaining items for the briefing book to the NACDD PSTAT consultant at least two weeks prior to the PSTAT visit. All items will be provided to the PSTAT consultant team prior to the site visit for advance review and use during the site visit. After the PSTAT visit, a summary of the PSTAT visit evaluation, any items developed during the PSTAT visit and follow-up conference call notes will be added to the PSTAT Briefing Book to develop the DPCP s final PSTAT report. Checklists (Appendix G) have been developed to help the DPCP and the PSTAT consultant keep track of all briefing book and final report documents. 15

16 PSTAT VISIT LOGISTICS Hotel, Transportation and Meals The DPCP is responsible for helping the NACDD PSTAT consultant identify 2-3 hotels in convenient proximity to the health department. Preference is given to non-smoking hotels and those with an on-site restaurant, business center and hospitality rooms for team meetings. DPCPs are welcome to coordinate lodging arrangements for the PSTAT consultant team. If the DPCP elects to provide this assistance, individual hotel confirmations should be sent to each team member. A single room must be reserved for each PSTAT consultant team member. The DPCP should provide the PSTAT consultant team with information on ground transportation between the airport and the hotel, and between the hotel and health department. In some instances, the PSTAT consultant team will have access to a rental car. Team members are responsible for all upfront travel expenses. If the NACDD travel agency is used, airline accommodations will be covered directly by NACDD. NACDD will reimburse PSTAT consultant team members for all lodging, ground transportation and per diem expenses acquired during the PSTAT visit in compliance with NACDD travel guidelines. NACDD is unable to provide breakfast or lunch during the site visit and cannot reimburse the DPCP for any expenses incurred on food, snacks or beverages. The DPCP will assist the PSTAT consultant team in identifying eateries in close proximity to the health department. If lunch will be provided by the DPCP or its partners, the DPCP should also assist the PSTAT consultant team in making any advance lunch orders. Meeting Space, Equipment and Supplies The DPCP is required to provide a comfortable meeting space that can be used consistently throughout the PSTAT visit and allows for PSTAT consultant team members to leave items in the room, if necessary. The meeting room should allow adequate wall space for overhead projection of Microsoft PowerPoint presentations and document review. Team members will bring a laptop computer for trainings and document reviews; and a laptop computer to record meeting discussions. The DPCP should inform PSTAT consultant team members of restroom locations and places to access water and hot and cold drinks during the site visit. DPCPs are welcome to provide table tents and name tags for all site visit participants. DPCPs must be prepared to provide additional support as requested by the team (e.g., photocopier, printer, etc). 16

17 PSTAT VISIT The PSTAT consultant team will be on-site for 1½ days providing technical assistance sessions, which include identifying and engaging stakeholders, conducting a situational analysis, developing an advocacy plan and producing products or tools to address the policy issue. The PSTAT consultant team, DPCP and stakeholders may begin to implement the advocacy plan, as appropriate, during the site visit. The site visit should only be scheduled when the DPCP, internal and external partners can devote their time and focus to the site visit s efforts. A draft PSTAT visit agenda is provided in Appendix I. Debriefing Sessions Debriefing sessions will be conducted at the close of each day. All PSTAT team members, DPCP staff and stakeholders are encouraged to participate in this activity. The PSTAT team leader will facilitate the debriefing discussion. Appendix J provides a draft list of items to be discussed during the debriefing session. PSTAT Consultant Team Meetings During the site visit, PSTAT consultant team members will conduct group meetings to discuss the progress of the site visit and any issues or concerns presented by the DPCP or partners. The DPCP may be asked to ensure that the meeting space remains accessible to the PSTAT consultant team for an additional hour after the adjournment of the site visit meeting. The PSTAT consultant team will also conduct dinner and/or evening meetings to discuss site visit issues and prepare for the next day s activities. A team meeting will also be convened to develop a draft advocacy plan. Advocacy Plan The PSTAT consultant team will assist the DPCP team in developing an advocacy plan specific to the policy issue. The DPCP team will be asked to complete a series of advocacy plan exercises designed to help the DPCP develop an advocacy plan (see Appendix I for draft agenda). The PSTAT consultant team will meet to compile all advocacy plan handouts and to develop a draft advocacy plan for group review and discussion. Time permitting, the DPCP will be asked to select a strategy to begin implementing with the assistance of the PSTAT consultant team. Wrap Up The last day of the PSTAT visit will be used to conduct a final review of the advocacy plan, discuss PSTAT team implementation tips and DPCP team next steps, and complete PSTAT visit evaluation documents (Appendix K). The PSTAT consultant team lead will facilitate this discussion with all PSTAT visit participants, and discuss next steps and future evaluation activities with the DPCP. 17

18 PSTAT EVALUATION AND FOLLOW-UP Following the PSTAT visit, the PSTAT subcommittee, PSTAT consultant team and DPCP staff will evaluate the PSTAT project s technical assistance process, any impact the site visit had on the policy issue, and the impact on the DPCP s capacity to engage stakeholders and effectively apply information and resources to influence policy changes. PSTAT Evaluation The DPCP will be asked to complete the site visit evaluation on the final day of the PSTAT visit. The DPCP is also responsible for completing and submitting the post site visit PSTAT Readiness Assessment to the NACDD PSTAT consultant after the site visit. The NACDD PSTAT consultant will keep the DPCP informed of any additional communication or documentation needed to complete evaluation activities. DPCP PSTAT Final Report At the conclusion of the PSTAT visit and evaluation activities, all documents acquired during the PSTAT process will be combined to develop a final report for the DPCP s PSTAT experience. The final report will consist of the original DPCP PSTAT Request, DPCP briefing book documents and summaries of all evaluation forms. Development of the DPCP final PSTAT report will be the responsibility of the PSTAT subcommittee member designated to serve as the subcommittee lead for the DPCP site visit. The DPCP s PSTAT final report will be provided to the NACDD PSTAT consultant and used to guide future advocacy training and technical assistance. PSTAT Consultant Team Pool After receiving technical assistance, the DPCP will be asked to share its experience with other DPCPs by becoming a part of the PSTAT consultant team pool or assisting with future advocacy trainings. Thank You Correspondence The DPCP is encouraged to send a thank you note or letter to each DPCP team member and the health official to thank them for their participation and/or support. 18

19 ADVOCACY OVERVIEW Advocacy is the act or process of advocating or supporting a cause or proposal (Advocacy, 2009). The goal of advocacy is to transfer information/provide education. The goal of lobbying is to influence a legislator to action on a specific piece of legislation. Most DPCP (state, U.S. territory, District of Columbia) employees are ethically able to advocate for change that benefits society using research, educational materials, personal stories, etc. Requests for action, even substantive action on a specific piece of legislation, is considered lobbying and falls outside of the scope of ethical conduct for most DPCP employees. Many agencies utilize the professional services of lobbyists to perform these activities. DPCP employees may make requests of legislators for causes important to them on their personal time; yet, an employee s expertise on a subject may transcend the personal right to communicate with an individual legislator even outside of work. State, U.S. territorial and District of Columbia laws vary widely. Check with your legislative liaison, or legal department, prior to initiating communication with legislators. When considering advocacy activities, DPCPs should ALWAYS operate within state, U.S. territorial or District of Columbia guidelines. Recipients of CDC or other federal and foundation funding should also operate within their advocacy/lobbying guidelines, including the Hatch Act for State and Local Employees. The Hatch Act restricts the political activity of executive branch employees of the federal government, District of Columbia government and some state and local employees who work in connection with federally funded programs (U.S. Office of Special Counsel, 2009). For example, you must never use federal dollars to lobby. When you meet/talk with legislators, you cannot advocate for funding or a specific vote on proposed legislation. Check with your supervisor and/or grant administrator to make sure you re operating in the confines of state, U.S. territorial, District of Columbia or federal requirements. It is always a good idea to check with your supervisor and/or grant administrator to inform them of your interest in contacting a legislator. In general, DPCP employees can: Meet with a legislator to discuss a public health or social problem as an overall educational strategy that is not tied to specific legislation. Respond to a legislative request for data, information, or educational material and present this information in a technical and factual manner. Provide legislators with background and educational material relevant to specific legislation that does not call for action on that legislation. Discuss your position - or your program's position - on a policy issue or issues. Keep in mind, the discussion should not advocate for a specific view or vote on the legislation. Discuss specific pieces of legislation and their public health/social impact in response to a direct request from a legislator, as long as you do not advocate for a specific view or vote on that legislation. Track legislators positions, votes, and contributions accepted. Participate in non-partisan analysis on policy issues, including specific legislative issues. 19

20 Meet or contact your personal legislative representatives as a private citizen on your personal time and with your personal communication devices and . Lobbying Restrictions as Outlined in Federal Regulatory Documents Office of Management and Budget Circular A-87: Cost Principles for State, Local, and Indian Tribal Governments General unallowable costs The cost of certain influencing activities associated with obtaining grants, contracts, cooperative agreements, or loans is an unallowable cost. Lobbying with respect to certain grants, contracts, cooperative agreements, and loans shall be governed by the common rule, "New Restrictions on Lobbying" published at 55 FR 6736 (February 26, 1990), including definitions, and the Office of Management and Budget "Government-wide Guidance for New Restrictions on Lobbying" and notices published at 54 FR (December 20, 1989), 55 FR (June 15, 1990), and 57 FR 1772 (January 15, 1992), respectively. Executive lobbying costs Costs incurred in attempting to improperly influence either directly or indirectly, an employee or officer of the Executive Branch of the Federal Government to give consideration or to act regarding a sponsored agreement or a regulatory matter are unallowable. o Improper influence means any influence that induces or tends to induce a Federal employee or officer to give consideration or to act regarding a federally-sponsored agreement or regulatory matter on any basis other than the merits of the matter. Hatch Act for State and Local Employees Permitted activities for covered state and local employees Run for public office in nonpartisan elections Campaign for and hold office in political clubs and organizations Actively campaign for candidates for public office in partisan and nonpartisan elections Contribute money to political organizations and attend political fundraising functions Prohibited activities for covered state and local employees Be candidates for public office in a partisan election Use official authority or influence to interfere with or affect the results of an election or nomination Directly or indirectly coerce contributions from subordinates in support of a political party or candidate 20

21 Appendices 21

22 1. DPCP identifies an emerging policy issue APPENDIX A: PSTAT PROCESS CHART 2. DPCP Reviews PSTAT Manual 19. Conduct follow-up evaluation 3. Complete and submit PSTAT request documents 18. Evaluate TA process and any impact 4. PSTAT subcommittee reviews document 17. Implement strategies and advocacy plan 16. Develop Advocacy Plan 5. Proceed with PSTAT request 5a. No - Refer to other resources 14. Conduct PSTAT visit 15. PSTAT and DPCP identify strategies 5b. Yes - State conference call if additional information is needed 13. Finalize travel and meeting logistics 6. Proceed with PSTAT request 6a. No - Refer to other resources 12. Finalize site visit agenda 6b. Yes - PSTAT subcommittee confirms approval 11. DPCP and PSTAT team conference calls 7. PSTAT Consultant contacts Advocacy Expert, ADA Advocacy Director and CDC Project Officer 10. Briefing book provided to PSTAT consultant team 9. State submits remaining documents for briefing book PSTAT consultant team convenes by conference call for orientation 22

23 APPENDIX B PSTAT REQUEST CHECKLIST Item Document Completed 1 Letter of Intent form, including consent of authorized official (signature obtained from official) 2 Background form 3 PSTAT visit calendar options 4 DPCP organizational chart 5 6 Health department organizational chart (Be sure to indicate the division/department/bureau in which the DPCP sits if it is not already indicated on the chart) Initial contact has been made to obtain a copy of the health department s advocacy policy statement? 23

24 APPENDIX C LETTER OF INTENT FORM INSTRUCTIONS Contact Information Please provide contact information for your DPCP. The primary contact person must be a representative of the DPCP seeking the PSTAT request. The secondary contact can be another DPCP staff member or an official that directly supervises the highest official in the DPCP. Consent from Authorized Official Having the support of a higher level official can significantly contribute to the success of the PSTAT process and subsequent advocacy activities. A higher level official is a senior Department official who is organizationally above the most senior person in the DPCP. This person can be the Chronic Disease Director, Bureau Director or the state, U.S. territory, or District of Columbia Health Official or their designee. Please use the section at the bottom of the Letter of Intent to indicate that the DPCP has received the support of a higher level official to complete the PSTAT process. This does not obligate the official to participate in the PSTAT visit or follow-up activities. 24

25 PSTAT REQUEST Letter of Intent Form Program Name Date Primary Contact Person Name Address City, State or Territory Phone Title Zip Code Fax Secondary Contact Person Name Address City, State or Territory Phone Title Zip Code Fax Signed Date Consent from Authorized Official As an authorized representative of the, I invite the NACDD Diabetes Council Policy and State Technical Assistance Team to provide technical assistance to the Diabetes Prevention and Control Program to construct an advocacy plan for the specified diabetes-related emerging policy issue. Print Name Signature Title Date 25

26 APPENDIX D PSTAT REQUEST, Background Form Please use the space below to provide background information on the policy issue in your state, U.S. territory, or District of Columbia. Limit response to a maximum of three pages. Please answer each of the following questions. If the question is not relevant to the issue, please write Not Applicable for the answer. Please check the type of issue this is: * Capacity Building Emerging * Immediate * Technical assistance for capacity building and immediate policy issues is not available at this time. Has the bill already been introduced? Yes No Not applicable Briefly describe the policy issue for which you seek technical assistance. Is the policy proposing a modification to an existing resource and/or service? What is the actual or proposed impact on people with diabetes or subgroups within the diabetes population (geographic, demographics, socioeconomic status, etc.)? 1. When was the policy change/legislation introduced? 2. Is the policy response time-sensitive? If yes, please describe. 3. When is a policy response needed? Provide as much information as possible on the amount of time available to respond to this policy issue. 4. Please describe any relevant historical background on the policy issue (if applicable). 5. Who are the key players (opponents and supporters)? 6. Are there any advocacy-related activities currently taking place or that have been conducted to address the policy issue? Who is doing what (within DPCP and external)? Who did what (i.e. advocacy-related activities no longer taking place)? 6A. Which stakeholders are involved? 6B. Which stakeholders are not involved but should be? 7. What do you hope to gain or receive from the PSTAT consultant team? 8. List potential DPCP team members (see pages 14 for recommended team members), their organizations, and their positions within the organization. 26

27 APPENDIX E PSTAT REQUEST Site Visit Dates Program Name Date Primary Contact Person Title The PSTAT visit will last 1 ½ days. Use the space provided below to select up to three choices for the best 1 ½ consecutive days to complete the site visit. Please allow at least three months for advance planning and site visit preparation. Choice #1: Month Dates Choice #2: Month Dates Choice #3: Month Dates 27

28 APPENDIX F READINESS ASSESSMENT The PSTAT Readiness Assessment is a tool to assess advocacy-related attitudes, behaviors and skills sets of the DPCP as well as the policy, environmental and organizational context in which the DPCP seeks to conduct advocacy activities. The Readiness Assessment is also a part of the evaluation process and will serve as a way to determine if the PSTAT visit had any impact on areas assessed in the tool. Prior to the visit, the PSTAT consultant will send the DPCP director/coordinator and staff a link to the online readiness assessment. The DPCP will be asked to have each of their staff complete the assessment. The PSTAT consultant will compile aggregate results of the assessment and provide to the PSTAT consultant team prior as part of the briefing book. The PSTAT consultant team will use the results to customize technical assistance to meet the needs of the DPCP. 28

29 APPENDIX G PSTAT BRIEFING BOOK The PSTAT Briefing Book is a compilation of all documents provided by the DPCP and items developed or acquired throughout the PSTAT process that will serve as a packet of essential information for the PSTAT consultant team. The PSTAT Briefing Book consists of the DPCP s PSTAT request documents, notes from the DPCP and PSTAT subcommittee conference call, notes from the DPCP and PSTAT consultant team call, PSTAT team notes and any reference items. PSTAT Briefing Book Contents: - PSTAT Letter of Intent - Selected site visit dates - Background form - Readiness Assessment (aggregate results of the pre-visit assessment) - DPCP organizational chart - Health department organizational chart - Health department advocacy policy - Conference call notes from the DPCP and PSTAT subcommittee call - Conference call notes from the DPCP and PSTAT consultant team call - PSTAT consultant team technical assistance notes - Reference documents for PSTAT visit The briefing book will also serve as a way to archive communication and technical assistance services provided to the DPCP for future reference. After the PSTAT visit, evaluation documents, any items developed during the PSTAT visit and follow-up conference call notes will be added to the PSTAT Briefing Book to develop the DPCP s final PSTAT packet. The following checklists will be used by the DPCP, PSTAT consultant, and PSTAT consultation team to track receipt of documents for the PSTAT Briefing Book and final DPCP PSTAT packet. 29

30 DPCP Name Form Completed By: PSTAT BRIEFING BOOK CHECKLIST Item 1 Document PSTAT request documents (LOI form, dates, background form, organizational charts and readiness assessment) 2 Health department advocacy policy 3 Conference call notes from the DPCP and PSTAT subcommittee call 4 Conference call notes from the DPCP and PSTAT team call 5 PSTAT team technical assistance notes 6 Reference documents for PSTAT visit DPCP PSTAT FINAL REPORT CHECKLIST Item 1 Document DPCP PSTAT Briefing Book (LOI form, dates, background form, organizational charts, etc.) 2 Evaluation documents 3 Follow-up communication notes 30

31 APPENDIX H PSTAT CONSULTANT TEAM ORIENTATION CONFERENCE CALLS PSTAT Consultant Team Orientation (Conference Call #1) Timing o At least one month before PSTAT visit o Try to limit to 1 hour, may be 1.5 hours Attendees and Roles o Diabetes Council Consultant Leads call Handles logistics for call, including scheduling call and sending out advance materials, such as PSTAT overview and team member bios o PSTAT Team Lead Co-leads call o PSTAT Team Members (ADA Regional Advocacy Director and CDC Project Officer or designee) Learn role in PSTAT process Content o Introductions o PSTAT overview (from written description) o Policy issue/needs Issue/need (more information to be provided in briefing book) Expected products/templates o Team member roles before, during, after PSTAT visit (Team Lead presents this section) o Travel arrangements o What to bring to visit o Any questions for PSTAT subcommittee or DPCP before the visit? PSTAT Consultant Team Call with DPCP Team Lead (Conference Call #2) Timing o After Conference Call #1; approximately two to three weeks before PSTAT visit o Try to limit to 1 hour Attendees and Roles o Diabetes Council PSTAT Consultant Leads call Handles logistics for call, including scheduling call and sending out advance materials o PSTAT Team Discusses policy issue with DPCP team lead and finalizes plans for the PSTAT visit PSTAT Team Lead facilitates discussion o DPCP Team Lead Discusses policy issue with DPCP consultant team and finalizes plans for the PSTAT visit Content o Review policy issue o Discuss and finalize DPCP team members o Finalize agenda o Determine need for additional tools or resources 31

32 PSTAT Consultant Team Call with DPCP Team (Conference Call #3) Timing o After Conference Call #2; approximately one to two weeks before PSTAT visit o Try to limit to 1 hour Attendees and Roles o Diabetes Council PSTAT Consultant Leads call Handles logistics for call, including scheduling call and sending out advance materials o PSTAT Team o DPCP Team Content o o CDC Project Officer or designee presents CDC Policy definition and DDT perspective Finalize any additional details for the PSTAT visit 32

33 APPENDIX I SUGGESTED SITE VISIT AGENDA * Final agenda will be based on DPCP and PSTAT team discussions Day 0 PSTAT Consultant team travels to designated state, U.S. territory, or District of Columbia; checks into hotel Dinner Consultant team meets to review agenda and assignment of tasks Day 1 Timeframe Topic Related Documents 9:00-9:30 am Welcome Meeting Logistics (restrooms, rules, etc.) Review PSTAT Confirm Deliverables for this Visit Introductions Review Agenda Agenda 9:30 10:00 am Review of DPCP policy issue and anticipated outcomes PSTAT Briefing Packet of the visit 10:00-10:30 am Developing an Advocacy Plan Developing an Advocacy Plan Presentation 10:30 10:45 am Break 10:45 11:45 am SWOT Analysis (Strengths, Weaknesses, Opportunities, and Threats) 11:45 1:00 pm Lunch 1:00 2:00 pm Successes and Lessons Learned (review examples of how other DPCPs addressed the policy issue) SWOT Analysis Handout PSTAT Briefing Packet Handouts from DPCP presenters 2:00 3:00 Advocacy Plan: Goals Advocacy Plan Handout 3:00-3:15 pm Break 3:15 4:00 pm Advocacy Plan: Resources Advocacy Plan Handout 4:00 4:10 pm Day 1 Debrief and Adjourn 5:00-6:30 pm PSTAT Consultant Team reconvenes at designated location at the hotel to review SWOT analysis and discuss implications for DPCP policy issue. Team identifies overall recommendations for advocacy plan and prepares presentation for discussion on Day 2 DPCP SWOT Analysis 33