In order to have power you have to give it away Ð It always comes back multiplied.

    During one meeting which included the Directors of Human Services, Mental Health, MR/DD, Juvenile Court Administrator and other system players the decision was made to pool funds for children in out of home care which had a treatment component. This meant that Mental Health would trust a collaborative management process for all children who needed to go to the hospital rather than managing their own hospitalization line item. Likewise the other systems were agreeing to trust each to other to manage a pooled fund for their most risky and most expensive service lines. The question came up of where to put the money if, indeed, it was to be pooled. The group looked at each system and recognized each other's strengths. The Mental Board operated with a minimal amount of administrative overhead and was not used to dealing with the kind of numbers the pooled fund would represent. MR/DD managed this resource in that system but was not used to dealing with the broad range of providers who would be accessed if the county put all of its eggs in one pooled basket. DHS was used to dealing with large numbers and a variety of providers as their system represented the highest number of children who accessed this type of care. The discussion continued for quite awhile about where to put the dollars. Finally, the DHS Director explained the way they claimed the 4E reimbursement which allowed them to pull down federal funds to reimburse the county. The other Directors unanimously agreed to move the pooled fund dollars through DHS. They knew if they were to move forward they would need to agree to share their authority and budgets with DHS.

When the initial visioning work is completed and some sort of structure is developed, a critical management principles is to avoid over controlling. Collaboration is an exercise in sharing power. Often these initial infrastructures are sunk when they begin to try to "own" other activities in the community. Frequently, these infrastructures become yet another system or bureaucratic place within the community. The end result can often be power struggles about who gets to control what and further divisions of an already shrinking service pie.

A constant refrain within the Family Council is to not assume that all collaborative efforts must be assigned to the Council. Recognizing that they got to where they are today by free participation, the Council makes no assumptions about what activities will be run through it. For example, a new pregnancy prevention grant may be available at the state level. Rather than assuming the Council should be the recipient or manager of these funds, Council staff will often recommend other groups to function as the fiscal agent or managing entity. Taking this approach allows key stakeholders to avoid a competition standard. The Council recognizes that it is only as powerful as the sum of its parts. The more parts and opportunities for participation the more powerful the Council will be. Since the infrastructure has been based on trust a logical extension of this trust is to recognize that they must trust key partners in the community to do their share. This plays out on both practice and administrative levels. As key System Executives trust each other and community players to do the right thing, staff and families are able to build that same level trust with families.

In developing a management culture which celebrates adaptability, flexibility and principled practice, Stark County avoids a focus on control. One key example involves the use of the mid-management group, ACCORD in managing and controlling funds spent either flexibly or on deep end care. In this case, ACCORD members realized that if they were only to exercise control over the pooled fund, they would eventually function only as gate-keepers for a magic pot of funds. In order to keep that from happening, ACCORD strategically set about changing the culture within the system. That culture change involved developing a sense of pride at the direct service level about not having to go to the ACCORD to accomplish things with a family. While approaching the ACCORD is an option to all direct service staff, it is expected that each system will equip staff with the tools necessary to solve problems as close to the family as possible.