3. Member Involvement and Retention
Member Involvement and Retention
CARE Act puts planning in the hands of groups broadly representative of the local community. In general, membership should be inclusive and as diversely representative as possible. This includes representatives from all populations directly impacted by HIV/AIDS and representatives from the broader health care community. The typical planning body is composed primarily of people directly involved with HIV/AIDS, either as consumers or providers of health care services. The more perspectives that are represented in the planning process, the better the chances that decisions will reflect community needs and be supported by participants and the broader community.
Multiple areas of expertise should be represented in the membership of a planning body. Examples include expertise in what it is like to live with HIV; expertise in how to deliver care and treatment programs to people living with HIV disease (PLWH); technical expertise in the health care planning activities required of the consortium including needs assessment, priority setting, comprehensive planning, resource allocation, and evaluation; and, expertise in group process.
A possible formula for membership recruitment and maintenance is: The better organized and operated, the easier it is to recruit new members and to retain current members. Members will feel that they are making a worthy contribution to an effective enterprise if the following holds true:
Some bodies distinguish between voting members and non-voting members. The latter are usually staff or board members of a lead agency or contracted service providers. Such entities feel that assigning voting privileges to these members could constitute a conflict of interest. Other groups allow only a designated number of voting members from each of the perspectives represented—consumer and provider. Additional representatives can participate as non-voting members. Finally, there are bodies that offer non-voting membership to people who cannot attend regularly, often for health reasons.
While the body guides planning locally, membership should not be a requirement to participate in planning. Nonmembers can contribute needed expertise through participation on selected committees, caucuses, and task forces and in surveys and focus groups to identify needs and service gaps. Some nonmembers with special expertise can be recruited to join in an advisory capacity, with limited duties. This has been used to involve experts, such as local physicians who may have limited time. They might be asked to review the needs assessment results and the draft comprehensive plan and give feedback.
Obstacles that can harm member participation include the following:
The following actions can help encourage participation:
Formal Membership Plan
Member recruitment and retention can be better tracked and analyzed by creating a formal membership plan that addresses (1) representation, (2) diversity (key occupational, geographic, demographic, and social characteristics representative of the area and population served by the body) and (3) recruitment and selection of members.
Representation means including different perspectives, such as the following:
Diversity should be based on population characteristics including the following:
A process for recruitment and selection of members may include answers to the following:
Each of these questions is addressed in greater detail in the Appendix at the end of this chapter.
Orient New Members
Orientation of new members helps them understand procedures and prepare to participate actively. Well-planned orientation and training activities demonstrates the value the group places on new member participation. Orientation activities might include the following:
The orientation manual should not be used as a substitute for an interactive orientation. Written materials should be compiled and adapted as necessary to accommodate the language preferences and literacy levels of new members.
Provide Ongoing Training for All Members
Continuing education and training opportunities promote constructive working relationships among members, reward members for their time and effort, develop members’ knowledge and skills related to HIV disease and organizational functioning, and advance the work of the group. The following educational opportunities can be useful for members:
Clearly Outline Roles and Responsibilities
Clear information will enhance functioning, including clearly defined roles and responsibilities; policies and procedures that are as simple as possible and available to all members in writing; and written definitions of all operating concepts. Use agreed-upon ground rules for all meetings. Conflict of interest and grievance policies and procedures should, at a minimum, be defined and distributed in writing to all members.
Further, CARE Act-specific activities require a high degree of definition to be successful. To illustrate, all services provided should be clearly defined before the needs assessment process begins. Establishing such definitions up-front is critical to the priority setting process, the resource allocations process, the comprehensive plan, and the evaluation process.
Create a Culturally Sensitive Environment
Never assume that there is only one way to conduct business of the group. The effort is a collaboration of many different people, all of whom bring their own expectations and backgrounds to the table. A formal process governed by parliamentary process and Robert’s Rules does not necessarily work in all environments. As needed, modify and create procedures for doing work that meet the needs of most members, promote full participation and high levels of productivity, and create a comfortable atmosphere that is inviting to new members.
Be Flexible about Meeting Times, Locations, and Participation Requirements
Meeting times, locations, and requirements for participation should be revisited on a regular basis. The group changes as new members join, older members leave, members die, and the requirements of the epidemic change. Many groups report changes in their PLWH participation as greater numbers of consumer members return to work or become employed. They have been forced to change their meeting times accordingly. Some are only meeting as a full body on a quarterly basis and rely more and more on committee functioning to complete the operational tasks. Some use consumer and service provider caucuses to review the work of the full group and provide input but do not require caucus members to participate in general membership meetings. The key is flexibility and taking the time to develop a process that works best.
PLWH Participation is a Priority
The following approaches will help assure PLWH participation:
Be Creative in Meeting Administrative Support Needs
Take the time to assess administrative support requirements and resources available to meet them. Do not assume some members will volunteer to do all the work or that the lead agency will automatically agree to donate those services.
First, discuss administrative requirements and develop an administrative budget with the State grantee and their lead agency (if they have one). If the administrative cap is inadequate to meet administrative needs, alternative resources need to be found. There are many creative solutions to the barrier of administrative support. Some groups recruit specific people or entities to make targeted contributions, such as small business owners willing to donate postage for mailing minutes as a sole contribution to the process. Others rely on local universities, colleges, or trade schools to provide interns to assist with the administrative tasks, such as taking meeting minutes. Some even use interns to write their applications. In other areas, groups from adjoining regions have combined their administrative allocations and contracted with a staff person to provide administration to multiple groups.
Take Action to Prevent Burnout and Help Sustain Member Commitment
Sustaining commitment and enthusiasm is challenging. All organizations experience an ebb and flow of involvement. Thus, it is important to bring in new members on an ongoing basis. They bring new energy and fresh perspectives. It is also important to rejuvenate existing members. Methods to sustain member commitment include the following:
Have a Membership Removal Process
Once criteria for membership have been established, adopt a process for removing members who no longer meet the criteria or who violate the rules. To discourage attempts at removal based solely on personality conflict, the removal process must be fair, impartial, and clearly spelled out. Use the following four steps, which are drawn from standard organizational personnel policies:
Step #1. Written notification to the member about the violation. This notice should specify actions necessary to correct the violation and the time frame within which the corrective action must occur. It is typically written by the principal leader or designee (e.g., the chair of the membership committee).
Step #2. A meeting to mediate a solution between the member or members and the principal leader or leadership such as the Executive Committee.
Step #3. Mediation and conflict resolution facilitated by an outside expert. This action should be taken if the member or members refuse to pursue a solution with the leadership.
Step #4. A motion to remove the member if all attempts at mediation fail. The motion should be introduced to the membership committee or the full membership, with complete written documentation of all prior steps taken. Removal usually requires a two-thirds vote of the members.
Recruitment and Selection Process
Address the following questions in the process that is established:
What Nominations Process Will Be Used?
An open nominations process might include the following minimum standards:
(1) Includes the legislatively required positions (membership categories)
(2) Reflects the epidemic of HIV disease in the EMA
(3) Reflects the geography of the EMA
(4) Reflects any other locally determined membership needs, and
(5) Incorporates conflict of interest requirements.
(1) The time commitments involved in serving on the planning body
(2) Conflict of interest standards, and
(3) HIV disclosure requirements.
(1) Collect information about the nominee’s characteristics, experience, and background, with specific attention to legislatively mandated membership categories and the characteristics of the local epidemic of HIV disease
(2) Include an open-ended response category for nominees to describe their experience
(3) Provide information to potential members about time commitments and other demands of planning body membership, meeting schedules, HIV disclosure requirements, and the conflict of interest standard, and
(4) Provide a written description of the nominations process.
Establish a representative nominations or membership committee that reviews all nominations.
How Will Members Be Recruited?
Methods for recruiting consortium members include:
SENSITIVITY TO SPECIAL NEEDS
With recruitment in mind, members should show sensitivity to the special needs of many targeted populations by providing, as appropriate, the following:
How Do Nonmembers Become Members, and what are the criteria for membership?
Following are ways for an individual to become a member. More than one of these processes might be used:
Criteria for membership may require the following of individual members:
What Are The Requirements To Maintain Membership?
Members may be required to do the following to maintain their membership:
What Training Will Be Available to Members
to Help Them Recruit New Members?
All members have an investment in new member recruitment and should be encouraged to participate in recruiting new members. The most successful recruitment technique identified by consortia across the country is the personal connection of asking someone directly to join. The best way to recruit a potential member on the importance of the group’s work is for someone with a prior personal connection to meet with him or her.
When meeting with a prospective member, do the following:
SAMPLE MEMBERSHIP COMMITMENT STATEMENT
Statement of Individual Consortium Member’s Responsibilities
I, _______________________________________________, do hereby commit to:
1. Know the Consortium’s mission, purpose, programs, and services. Continually work to develop and implement strategies, goals, policies, and procedures that promote the Consortium’s mission.
2. Work to attract new members who can make significant contributions to the work of the Consortium and reflect the diversity of the community and the HIV/AIDS epidemic.
3. Fulfill commitments made, willingly undertake special assignments, and consider serving in leadership positions.
4. Avoid prejudiced judgments on the basis of information received from individuals and urge those with grievances to follow established policies and procedures for grievances within the Consortium. (All matters of potential significance should be called to the attention of the Consortium’s leadership.)
5. Stay informed and follow the trends in the HIV/AIDS epidemic.
1. Prepare for and participate in Consortium meetings and committee meetings.
2. Ask timely and substantive questions at Consortium and committee meetings consistent with my conscience and convictions, while supporting the majority decision on issues decided by the Consortium.
3. Maintain confidentiality of the Consortium’s sessions and speak for the Consortium only when authorized to do so.
4. Suggest agenda items periodically for Consortium and committee meetings to ensure that significant policy-related matters are addressed.
1. Serve the HIV/AIDS community as a whole rather than only serving a special interest group, constituency or service provider. (It is very important that all the various perspectives of the HIV/AIDS epidemic be represented and participate in discussions. Ultimately, all Consortium members need to make final decisions for the good of the entire community.)
2. Avoid even the appearance of a conflict of interest that might embarrass the Consortium and jeopardize the credibility of the funds allocation process. Disclose any possible conflicts to the Consortium in a timely fashion.
3. Maintain independence and objectivity and do what a sense of fairness, ethics and personal integrity dictate even though not necessarily obliged to do so by law, regulation or custom.
4. Never accept (or offer) favors or gifts from (or to) anyone who is funded by the Consortium or does business with the Consortium.
1. Exercise prudence with the Consortium’s decisions regarding allocation of CARE Act Title II funds. I understand that we are the stewards of these public funds and our decisions about how to spend them must be made in a fair, impartial and informed way.
2. Faithfully read and understand the Consortium’s financial statements and budgets and otherwise help the Consortium fulfill its fiduciary responsibility.
Further, I personally commit to:
(For example: accomplish a specific task, sit on certain committees, take responsibility for certain functions of the Consortium, or take a particular leadership role.)
Signed: ___________________________________________ Date: _____________