The overall process is one that we have termed "grass-roots-up". What we mean is that we try to remain grounded in the concerns and ideals of members of the community, and draw from there as much as possible membership in working groups (Sub-Working Groups -SWGs- and Task Groups -TGs-), which are in turn directed by a steering group, the Transformation Working Group (TWG). MHT SIG Staff support this on one side with planning and organization, as Evaluation Team members support the process on the outher side with a focus on outcomes. A diagram may help to illustrate this.
First Year MHT SIG Process:
The volunteers recruited from the fourteen Town Hall meetings began their work in the SWGs, in September 2007, with monthly (or more frequent) meetings following. Focus was on developing three to five recommendations each to be considered as part of the CMHP. The SWGs brought together representatives from a full range of communities. This included rural and urban, multiple cultures and many roles. MHT SIG Staff attended each SWG meeting to provide support to the overall process. Evaluation Team members also served on each SWG to provide information and technical assistance in the form of responses to queries.
Hawai`i also had national assistance. The Western Interstate Commission for Higher Education (WICHE), the National GAINS Center and Hawaii‘s (children‘s) Communities of Practice (CoP) provided additional consultation on workforce development, criminal justice and children‘s issues, respectively. WICHE supported the work of the SWG 6 (Workforce) with a technical report and meeting; the GAINS Center and the CoP each helped start specific MHT SIG efforts we considered Task Groups (TG).
Following the grass roots design, the TWG was convened by the Governor in November of 2007. It brought together relevant Department Directors, community leaders in mental health, consumers and family members, as well as SWG Co-Chairs. As steering committee, the TWG was first briefed on the grant process and in January of 2008 received draft recommendations from each SWG for feedback. A second round of Town Hall Meetings in January and February allowed MHT SIG staff, SWG members and State Council for Mental Health members to present these recommendations to their communities for additional feedback.
Based on this input and with format guidance from MHT SIG staff, the SWGs updated their recommendations, each of which can be found in full in the Appendix of the original Comprehensive Mental Health Plan (CMHP). Staff drafted the CMHP framework and used all feedback to collect into a new chapter overarching and priority recommendations. This was placed at the end of the SWG/TG chapters. As a quasi Editorial Board, the TWG helped refine this chapter and considered the implications for Governance. Together, these two chapters represent the big picture of this CMHP. Final edits were made and presented back to the TWG and SWGs and the CMHP was submitted to the Governor in March.
Second Year MHT SIG Process:
The short second year was given to further refinement of the CMHP. To bring Hawaii’s process back in synch with other transformation states’ schedules, this phase was scheduled to last from April to September of 2008.
The first year’s plan had presented a total of 29 recommendations, each with significant detail. As the SWGs had rapidly worked to generate these recommendations, there was also overlap. Based on Federal and state (TWG) leadership direction, the task was to focus so that rapid implementation could begin. Accordingly, the recommendations were grouped by topic and referred to a new series of six Task Groups (TG) that were to develop work plans.
The TGs included: Educating the Public; Systems Integration; Professional and Consumer Workforce Development and Training; Research, Evaluation and Dissemination; Financing and Sustainability; and Criminal Justice. TGs were to concentrate on one area for action. These were to be transformational, feasible and sustainable in the new economic situation.
In addition to these TGs, MHT SIG had encountered a variety of critical activities that also included planning processes. These MHT SIG Initiatives included: Consumer, Family Member and Youth; Network of Care; Trauma-Informed Care; Children; Administrative Transformation; and Uluakupu Awards (mini grants).
Thus, together, a total of 12 Work Plans were developed that make up the bulk of the 2008 CMHP Update. While the end of the second year represents the formal end to planning and moves to implementation, ognoing adjustments as well as new opportunites will require constant attention, particularly at this time of financial crisis. A diagram may illustrate where we are now.