2024 All-America City – Monroe County, IN

In Monroe County, traditional approaches such as “3 minutes at the microphone” and strict adherence to Robert’s Rules of Order have been the norm for decades. However, residents and community stakeholders have begun to recognize and point out the limitations of these methods, particularly for historically marginalized and disadvantaged populations. 

Monroe County is now on a journey towards collaborative governance, demonstrating that these traditional bureaucratic approaches severely limit community members’ voices and hinder two-way communication, confining topics, people, and discussions within rigid boundaries that impede genuine feedback, active listening, and productive conversations. Consequently, the community is exploring new public engagement processes and approaches that prioritize giving significant voice to underrepresented individuals, ensuring they are heard and integrated into decision-making. 

Dialogue & Deliberation for Health 

In response to a lack of engagement processes for garnering community input in health decision-making, Monroe County initiated a comprehensive community engagement strategy. Initially, 46 interviews were conducted with residents to build trust, understand health concerns, and identify individuals interested in further participation. 

Subsequently, small group discussions in both English and Spanish, individual conversations, and online comment forms were utilized to gather personal health experiences. Identified community health concerns were integrated into an existing community health assessment and then deliberated upon in sessions with elected officials and other decision-makers to begin considering solutions. Community members also prioritized the results of the health assessment through professionally facilitated think tank discussions, which included a data walk consisting of large placards explaining community concerns and proposed solutions. 

Three priority areas for action were identified during the think tanks: 

  1. Poverty and accessing health and social services 
  2. Inequity, discrimination, and bias 
  3. Substance use and mental health 

A public kickoff event was held to present these priority areas and attract participants for eventual action teams. 

Community Voices for Health Monroe County (CVHMC) 

A challenge faced by Monroe County was to establish a fully inclusive and sustainable community engagement structure, supporting equity and diversity to address health issues and influence health decision-making and policy. To tackle this, several actions were taken:

Initially, project teams and an advisory council were formed, consisting of community justice advocates, public engagement experts, health professionals, researchers, and members from underserved communities. An Implementation Team executed the initiative under the guidance of a Steering Committee. 

The formation of the Monroe County Health Equity Council (MCHEC) emerged from discussions within the Advisory Council to sustain the project beyond its initial funding. MCHEC’s mission is to reduce health disparities by facilitating public engagement in policy decisions. It convenes stakeholders, recommends solutions based on community input, and collaborates with local governments to integrate health equity considerations into policymaking. 

MCHEC includes members from marginalized groups, social service agencies, and elected officials. Notably, elected officials actively engage in MCHEC’s committees, fostering inclusive policy discussions. 

Efforts were also made to engage elected officials through meetings and discussions on inclusive public engagement principles and Health in All Policies (HiAP) concepts. MCHEC focused on outreach to underrepresented residents, disseminating information about important community meetings and issues. 

The project’s outcomes include strong community support to continue the work independently, showcasing a ground-up approach to community-based research and policy-making that is unique in Indiana. The success of MCHEC aims to transform local decision-making and policies toward health equity. 

Community Voices for Health Indiana 

Monroe County faced the challenge of sharing what they learned from the CVHMC project with other communities in Indiana and beyond. To tackle this, they formed a Partners Council called Community Voices for Health Indiana (CVH Indiana). 

The Partners Council was instrumental in sharing information, resources, and guidance with other Indiana communities interested in similar public engagement initiatives. This effort included the development of a comprehensive Toolkit for Communities, aimed at inspiring and assisting other communities in undertaking similar work. Additionally, a Report to the Community was created to outline the project’s methodology, activities, and achievements, which was widely shared through presentations, social media, and electronic newsletters.

The CVHMC process served as a model for the Partners Council and was grounded in best practices in public engagement, community health, and existing planning processes. The Toolkit and related processes were shared at various exhibitions, roundtables, and conferences, both locally and nationally, to facilitate broader adoption and replication by other counties and organizations.

Overall, the initiative successfully disseminated its approach and findings, providing valuable resources to support equitable public engagement and decision-making processes in communities beyond Monroe County. 

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