Create “working propositions”

Family Health and Education Centers (FHEC) is a community health clinic system. Over a period of several months, the executive director and his staff came to see the importance of engaging the board around three strategic issues that had been emerging. A retreat was scheduled for purposes of considering these new initiatives.

Working with a subcommittee of the Board, three “working propositions” were developed prior to the retreat date. These propositions or “motions” were prepared to allow the board to begin its discussions. Each item was supported by a factual presentation.

In complex risk environments, boards are usually served by policy discussions that have a clear starting point.

While the use of a group has a time and place in the creation of strategy, the fact is that the strongest organizations are characterized by leaders who bring passion and clear senses of direction.

Through skillful presentation and translation, facilitative leaders help others to modify, understand, and embrace proposals. This is the up-front work that should drive the design and content of important meetings.

With the proper pre-agreements that authorize staff and committees to prepare proposals, strong boards will appreciate arriving at meetings and receiving clear alternatives, proposals, or recommendations. When full board deliberations start this way, board members are more likely to understand the content and have a basis for targeted discussion.

Effective staff leaders work the middle ground. At one extreme is board complacency, non-engagement, and rubber-stamping. At the other extreme are those long, circular discussions about “where we should be going” that lead again and again to nowhere. Both point to dysfunction.

Put draft proposals -“working propositions” – in front of the board:

To continue with the Family Health and Education Centers illustration, here are the three working propositions that were presented at the beginning of each of three retreat agenda segments:

  1. Amend FHEC’s capital budget to approve an expenditure of $75,000 for the planning of a new medical/dental clinic and administrative offices.
  2. Instruct FHEC’s management staff to continue exploration for the opening of a fourth medical clinic in the next 12 to 18 months. Location of the proposed medical clinic will be decided by board action upon completion of a more thorough needs assessment and review of potential clinic sites.
  3. For now, de-emphasize the strategy of budgeting managed care savings, but keep the option open for later consideration. Instruct FHEC’s management staff to develop plans that do not require utilizing managed care savings in developing operating budgets for expanded services.

At the retreat, each of these working propositions (or “recommendations”, or “motions”) received nearly two hours of attention, including overview, clarification, discussion and opinion, and modifications.

Board members agreed on a set of rules of engagement (see below) at the beginning of the day. Each section ended with polling of the group on the final language. Agreements were put in an eight-page detailed memo that reflected the context of the deliberations and the modifications to the original working propositions.

The organization had acted, and was moving forward.

Operationalize fairness by creating the rules of engagement:

A group can’t make effective decisions without first agreeing on the rules it will use. Substantive deliberations should not begin until the group has first agreed on the details of how it will do business.

Following are several sets of concepts to create a clear design and to manage expectations. In the case of the health clinic described above, many of the following ideas guided the discussions and the decision process.

  • Positioning statements
  • Conducting discussions
  • Key values
  • Consultant role
  • A discussion path for each item

Use the individual items as appropriate to your particular situation. Put them forward before you start making decisions, and use a tone that encourages discussion and understanding.

Positioning statements that consultants and chairs can consider using:

Select from the following six sets as needed, depending on the situation.

Preexisting agreements:

  • We agree on the rules and fairness of the processes we will use before we begin the actual deliberations.
  • Today is a partnership between staff and board. Staff are full participants.
  • The executive director (President, CEO, etc.) will be leading today via the presentation of proposals, which are best seen as “working propositions” and subject to modification.
  • As a board, we will use these working propositions as the bases for deliberation and for organizing our day.
  • We have configured our decision process today to the available time and to the available resources.

Today’s guidelines:

  • We’re here today as social entrepreneurs who must accept basic uncertainty and risk. An element of faith will be a part of decisions to proceed.
  • We agree to vote on the various working propositions on the basis of the experience and knowledge we each bring to the table.
  • We will seek a balance between:
    • your activist involvement in challenging directions, and
    • your acceptance of the work done by others (e.g., staff,  planning committee.)
  • We recognize that there has been a sincere desire on the part of staff and the planning committee to represent you properly in the retreat preparations and to involve you meaningfully.
  • We will see the meeting as part of a longer-term, ongoing effort to govern well. Some discussions may well end with:
    • A hand-off to a committee for further clarification
    • Further full board discussion at a later date
    • Referral back to the executive director for further work
  • We recognize that change is the status quo. There must be balance between a) tough adherence to principles and b) being influenced by new information.
  • If you believe a particular discussion is not on-point, raise it with the group. Remember, though, that being on-point might be in the eye of the beholder.
  • At the end of the allotted time for various items, we’ll poll the room using two criteria to gauge support for the emerging directions. These criteria are:
    • reasonableness
    • willingness to move to the next steps in implementation

Conducting discussions:

  • We will stay within the time limit for each section.
  • We’ll give everyone a chance to speak before second comments.
  • We ask for shorter comments.
  • We will limit discussion time under an assumption that people’s points of view can be known relatively quickly.
  • If you believe a particular discussion is not “on point,” raise it with the group. Remember that being “on point” might be in the eye of the beholder.
  • As we review the plan language, changes will occur-or not occur-as follows:
    • Modifications that are immediately and intuitively sensible to the group- and which require little discussion-will be included.
    • We will move away from proposals that do not resonate with the group fairly quickly.

Three key values:

  • We want to create full and open board and staff discussion. Be direct and honest about concerns.
  • We will all assume good faith and good intentions on the part of our peers.
  • We will accept the ambiguity and occasional chaos that come with real problem-solving and strategy-making.

Consultant’s role:

  • Try to represent all interests.
  • Test for agreement and consensus.
  • Create even participation.
  • Operate within agreed-on rules.

A discussion path for each working proposition:

  • Presentation of proposed directions.
  • Board members only can pose questions of clarification during the presentation
  • When the presentation is complete:
    • Collect opinions and preferences from the board.
    • Collect statements of support for particular items
    • Collect statements of concern (general or specific omissions, needed modifications, etc.).
  • General discussion and modification of language when the group agrees relatively quickly.

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