IS YOUR ORGANIZATION READY?

As much as it is critical to pair the right peer or mentor with the right mentee as Tony has shared, assessing if your organization is ready is an equally important step in peer program development or enhancement. If an organization is not prepared to support a peer program, the likelihood of success deminishes. Therefore, organizations should conduct an assessment of both their capacity to build a peer program and their ability to sustain the program. This means that an organization needs to value the concept of peer support in order to provide the necessary resources for that program.

Resources might include: the accessibility and support of key organization decision-makers; the use of available dollars; management structure; peer support; and focused efforts on creating a multidisciplinary care team.

Each phase of this process needs to include those decision makers and stakeholders who have a vested interest in the program. It is ideal for one or two point people to emerge as the champions or leaders of the process of assessment to determine the information to be gathered, analyze results, and share and act upon the results.

Table 3: Organizational Readiness on page 13

provides a phase-based breakdown of considerations that may help organize your actions and guide your organization through its assessment. The information captured from the organizational assessment will also support the development of a Peer-led Support Program Plan. See Appendix B: Sample Peer-led Support Program Plan, pages 39 and 40.

Special Considerations

If your organization is ready to employ SMEs it is important to remember that some PWH may be receiving social benefits which could be impacted by taking a salaried job. Before recruiting PWH to serve as SME, gather the necessary information from the Social Security Administration or the State’s Human Resources Department on how a salaried position could impact a candidate’s benefits, such as Supplemental Social Security income (SSI) or Social Security Disability insurance (SSDI), Medicaid, housing subsidies, or food and nutritional benefits (e.g., SNAP, WIC). Taking on a paid position could reduce those benefits for candidates in these situations.

However, creative minds are able to find different ways that will not conflict with government benefits, think about: hourly positions instead of a salary, provide contract work, allowances, stipends and/or honorariums. Offering such information upfront will facilitate the hiring process, making it more efficient and transparent. Additionally, encourage candidates to seek out this information independently to ensure their understanding. These important steps will help you support staff retention for the care team as well as the agency overall.

Table 3 Organizational Readiness

Phase 1

Program Conceptualization An initial understanding of the rationale or need for the development or enhancement of a peer program and determining what needs to be accomplished with a peer program. The first step is to identify why the peer program is crucial and what it ideally should look like when operating at its best. In this way, there is a common goal/ vision that directs how the program gets developed or enhanced. In order to create a program goal/ vision, the following questions should be answered: a. Why is having or enhancing a peer program important? b.What are the goals or expected outcomes of a peer program? c. How does this peer program fit the organization’s mission and existing services? d.What will the program look like when these goals are being met? e. Who needs to be involved in the peer program and at what phases in the process? f. What are the funding options for a peer program? g.Why is having or enhancing a peer program important?

Phase 2

Gathering Information

Phase 3

Program Development Process That can help determine the readiness of the organization to develop and implement a peer program, including the organization’s current strengths or capacity Using formal assessment tools may help an organization think through its program readiness. It is important to think about who should be part of the assessment process. a. Who are the decision makers at the organization? b.Who understands peer programs from a range of perspectives (consumers, clients, patients, program staff, etc.)? c. Who from the community could serve as a support or referral mechanism? d.Who is invested in the success of the peer program?

Creating a development road map (program planning worksheet) that serves as a guide during the start-up or enhancement. The third phase addresses all of the programmatic and organizational issues that were identified by assessment tools by using both a work plan and a program planning tool to direct activities toward the goal of program development or enhancement. • A work plan is an ideal way to put the program vision down on paper. • It is important to outline and include objectives, activities, and evaluation methods.

Objectives are concrete descriptions of the changes to services as a result of the peer program. • Activities describe exactly what peers and other key staff or community members will do and the resources that may be needed to achieve objectives and goals. • Evaluation measures and methods are proposed mechanisms for determining if the goals and objectives of the program were met.

Key Organizational Considerations

• What is the breakdown of the recipient population to be served? • What are the social demographics of the recipient population? • How many recipients can benefit from peer engagement? • What organizational beliefs and attitudes influence peer integration practices? • What types of policies and procedures are needed for peer integration? • Which stakeholders need to be included in the planning and development? • What type of staff development and training is needed to support peer based programs? • What are some potential barriers to program and service implementation? • How can peers be trained on evidence based practices and interventions to ensure effective service delivery and quality care?

OPINION STATEMENT A Doctor’s Perspective

“As a physician and MAO’s Medical Director, every day I see patients who are newly diagnosed with HIV and coming in for that critical first appointment with our clinic. Medically, HIV has evolved into a chronic condition that is very treatable and manageable - one pill, once a day is enough for almost everyone to stay healthy. But any medical center that approaches treating HIV that simply will fail their patients.

Peer support is crucial to treating people instead of just treating the virus. Treating people with HIV means addressing stigma, building up self-worth that has been chipped away, repairing relationships after years of mistreatment by the medical system, confronting biases, and fighting against social inequities.

The patients I see who are new to HIV care so often come wrapped in a tight shell, unable to open up or trust the healthcare team because of all they have been through before. They come in believing they are going to die, or that no one will ever love them again, or that they cannot tell anyone what they are going through. Those are heavy, heavy burdens to carry, and for some patients just participating in their care - taking medicat ions, coming to appointments - becomes such a horrible reminder of their HIV status that they stop. As much as I think our team of physicians and nurses cares deeply and tries to break through, there is just nothing like having a peer support person who can come in and say, ‘I’ve been where you are, I know those feelings, and you are going to be OK.’ That bridge away from isolation can make all the difference.

There is a growing and identified need for passionate leaders who have particular interest in managing their health, as well as purpose for improving health and social services to their community. See the value of peer support workers. Be clear about the roles you need or would like them to play. Also, be clear to them and to yourself about your organization’s expectations. And, most important, make sure your organization and existing team members are prepared to support your peer support workers.”

Cordelia Stearns, MD, AAHIVS

DEBORAH:

“Educate yourself! Talk about HIV. It doesn’t rub off.”