In 2015, Clinton County, NY, was one of six grantees to be part of the New York State Health Foundation’s (NYSHealth) Healthy Neighborhoods Initiative (HNI). In Clinton County, the initiative was led by Clinton County Health Department’s (CCHD) Health Planning & Promotion Division, directed by Mandy Snay and coordinated by Karen Derusha, Alexandra Mesick, Amanda Prenoveau, and Lisa Turner. The HNI was a new endeavor for the health department that sought to develop partnerships with town officials throughout the county and provide skill-building opportunities, education, and mini-grants for built-environment projects. Healthy Places by Design talked to Mandy about her experiences, here are highlights from our conversation.
MS: My role changed some over time, from program implementation to oversight. I was responsible for staff supervision and provided guidance to our team about adjustments to plans and how best to meet goals.
I can honestly say the connection to other people who understand this built-environment work and its impact on life-long health made an impression on me. One of our goals was to start building a local team that believed in that work, too. Even within our own department, our work is often misunderstood, so whenever we got together in HNI learning sessions or even virtual calls, it was just so motivating and reassuring to see and hear about the work that other coordinators were doing that was very similar to ours. It meant that we weren’t just these “misfits.” We are doing work that’s worth the time and resources to do. Sometimes, people within our own organization assume that our work is just for fun, or it’s silly, or it’s easy. It’s really not. It takes a different kind of health professional to do this work because you don’t see immediate results. It changed how we recruit and what we’re looking for in people. It’s important to find people who don’t need that instantaneous gratification.
We were often hindered by competing priorities and, obviously, by the pandemic. We also faced constant turnover internally and with our partners. We have wonderful advocates in our community, but sometimes it seems we take ten steps forward and then five steps back. We can invest a lot in nurturing an advocate who then retires or moves on. For example, a woman from one of the local towns was an early adopter. She was great at writing grants, always attended meetings, and participated actively. She pushed her town to be better and to look forward, but she eventually moved on from that role. There hasn’t been a strong advocate to take her place. In other instances, we saw supportive elected officials move on as their terms ended.
I’m proud of the future impact of our work in the county. I’m proud of the growing interest among the local governments and townships, and how those towns responded when we pointed out what other communities were doing or how they were progressing. I’m blown away every time I talk to potential new partners because their interest is so high, especially among elected officials. We even had to turn a few people down for mini-grants in recent rounds and rather than giving up, it inspired them to ask how they could do better in their next applications, which is exactly the attitude we want them to have.
"I'm proud of the growing interest among the local governments and townships, and how those towns and communities responded when we pointed out what other communities were doing or how they were progressing."
The most direct impact was on township leadership. As we were putting out small funding opportunities, such as mini-grants, so many of our partners participated in those opportunities and were looking to do things in their own communities. I know we were somewhat different from other HNI grantees because we were spreading the funding across different sectors versus having a very focused project in a single neighborhood. The county has very distinct townships and they are each different in their own ways. We felt it was important to support as many communities as possible. After the work is done, they will continue to be advocates in the future. We’ve been able to build their skills so next time they can do this work on their own and not rely on us. I’m very proud of that.
We also saw an impact on our team’s confidence within the health department. I have definitely seen a pattern where the health department did not want to let things go when our partners developed skills to accomplish things independently. Some wondered, “Why would we give our work away? What else are we going to do?” But there’s so much else to do in public health. When we can empower our partners with the skills we have, or take on this work themselves, it means we can revisit other unaddressed public health problems and start checking them off the list. It’s a really refreshing approach and I’m proud of our team for being comfortable and confident enough to trust in that process.
My advice is to expect turnover and try not to put all your eggs in one basket. Continued flexibility from NYSHealth helped us go down other avenues when we needed to alter certain deliverables.
As a result of the HNI and the pandemic, we started planning more realistically. Everything takes more time than you expect. We always thought we’d be able to move faster, but we always ended up feeling behind. For coordinators making a work plan, add two to three months to what you think it will take. There are always unforeseen hold-ups, like turnover in staff and leadership. And then, when working with partners, think about how much anxiety you create when we push forward too quickly. Give it time.
"When working with partners, think about how much anxiety you create when we push forward too quickly. Give it time."
What allowed us to build a strong foundation was the additional time provided to us by NYSHealth. Knowing we had that leeway we were able to make so much progress. Community health initiatives should be given five years, at least. Better yet, a ten-year grant—how fantastic that would be?! Longer-term funding gives staff the confidence that their jobs won’t go away.
Funders should know that the connection to other people doing similar work is also very reinforcing. Access to technical assistance and education to build skills was an important bonus, too. It would be amazing if every funder gave this level of support. If nothing else, we would have appreciated more examples from rural communities. But there was still so much to learn from some very urban communities, which was eye-opening.