Partnerships:Partnerships:Analysis and AdviceAnalysis and Advice
Stephen H. Linder, Ph.D.Stephen H. Linder, Ph.D.
Interim Director, Institute for Health PolicyInterim Director, Institute for Health Policy
The University of Texas School of Public HealthThe University of Texas School of Public Health
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OriginsOrigins
Roman Law of InheritanceRoman Law of Inheritance Medieval Property PartitionsMedieval Property Partitions DiplomacyDiplomacy CommerceCommerce ProfessionsProfessions
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Commercial CodeCommercial Code
Jointness + Fair DivisionJointness + Fair Division
Sharing Profits and LossesSharing Profits and Losses Bear some risk, Bear some risk, pay some cost, pay some cost, share some gainshare some gain
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Positive ConnotationsPositive Connotations
Diplomacy – “peace, neighborliness, Diplomacy – “peace, neighborliness, prosperity”prosperity”
Professions – “proven and Professions – “proven and accomplished”accomplished”
Commerce – “shrewd, Commerce – “shrewd, entrepreneurial and efficient” entrepreneurial and efficient”
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Separating RolesSeparating Roles
Partners v.Partners v.CompetitorsCompetitors
ClientsClients
CustomersCustomers
AgentsAgents
ContractorsContractors
SubordinatesSubordinates
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The Feds and FoundationsThe Feds and Foundations
Partners to share the burdensPartners to share the burdens Partners to assume responsibilitiesPartners to assume responsibilities Partners to leverage resourcesPartners to leverage resources Partners for cooperationPartners for cooperation Partners as mid-way to privatization Partners as mid-way to privatization
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Principal-Agent v. Principal-Agent v. PartnershipPartnership
Resource FlowsResource Flows Know-HowKnow-How ControlControl
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The Symmetry TestThe Symmetry Test
Formulation Formulation Measure of Control Over TermsMeasure of Control Over Terms
FunctionFunction Resource CommitmentResource Commitment Shared FateShared Fate
“ “Fair Division” Fair Division” “Fair Division” “Fair Division”
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From Potential Ally to From Potential Ally to PartnerPartner
Less DemandingLess Demanding
1.1. Perceived mutual advantagePerceived mutual advantage
2.2. Mutually agreed upon objectivesMutually agreed upon objectives
3.3. Shared commitmentShared commitment
4.4. Pooled resourcesPooled resources
5.5. Shared accountabilityShared accountability
6.6. Shared formulation and functionShared formulation and function
More DemandingMore Demanding
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Relationships between stakeholdersRelationships between stakeholders
Less DemandingLess Demanding
1.1. Networking – exchange informationNetworking – exchange information
2.2. Coordination – alter activity to avoid conflicts Coordination – alter activity to avoid conflicts
3.3. Cooperation – share resourcesCooperation – share resources
4.4. Collaboration – share risks and rewardsCollaboration – share risks and rewards
5.5. Partnership – stable, fair divisionPartnership – stable, fair division
More DemandingMore Demanding
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MotivesMotives
Why partner?Why partner?
Economic reasonsEconomic reasons
Leverage Resources – New CapitalLeverage Resources – New Capital Complement Assets – know-how, expertiseComplement Assets – know-how, expertise Shortcut Administrative ChannelsShortcut Administrative Channels Efficiency GainsEfficiency Gains
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Why Partner?Why Partner?
Social reasonsSocial reasons Nurture Civic CultureNurture Civic Culture Reduce ConflictReduce Conflict Promote EngagementPromote Engagement Encourage CooperationEncourage Cooperation Community-BuildingCommunity-Building Symbolize SuccessSymbolize Success SustainabilitySustainability
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Why Partner?Why Partner?
Political ReasonsPolitical Reasons
Expand Legitimacy & SupportExpand Legitimacy & Support Spread ResponsibilitySpread Responsibility Increase InfluenceIncrease Influence Avoid Narrow AccountabilityAvoid Narrow Accountability Cooptation of Potential RivalsCooptation of Potential Rivals Promote Market-Oriented ValuesPromote Market-Oriented Values
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Our Sectoral ComplexOur Sectoral Complex What is public and what is private?What is public and what is private?
Changing American ideasChanging American ideas
Domains -- economy, householdDomains -- economy, household Rights claimsRights claims Limited governmentLimited government
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Efforts to keep Public and Private separateEfforts to keep Public and Private separate
Use Organization typesUse Organization types
Government (courts, agencies, elected officials)Government (courts, agencies, elected officials) Business (e.g., Microsoft Corporation) Business (e.g., Microsoft Corporation) Voluntary Private Organizations (e.g., Planned Voluntary Private Organizations (e.g., Planned
Parenthood) Parenthood) Non-governmental Organizations (e.g., United Way)Non-governmental Organizations (e.g., United Way)
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More Efforts to keep Public and Private More Efforts to keep Public and Private separate separate
Use Legal definitionsUse Legal definitions
Public -- taxes and sovereign immunityPublic -- taxes and sovereign immunity For-profit -- commerce and incorporation For-profit -- commerce and incorporation Nonprofit -- gifts and tax breaksNonprofit -- gifts and tax breaks
Use forms of governanceUse forms of governance
The State -- Elected Officeholders for VotersThe State -- Elected Officeholders for Voters The Firm -- Board of Directors for StockholdersThe Firm -- Board of Directors for Stockholders The Organization -- Community BoardThe Organization -- Community Board
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Post World War II Consensus Post World War II Consensus
(Limited Welfare State)(Limited Welfare State)
Public – common defense and market Public – common defense and market interventionintervention
Private – economic growth and employmentPrivate – economic growth and employment
Voluntary – social stability and inequalityVoluntary – social stability and inequality
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Post-Reagan Consensus Post-Reagan Consensus
(Devolution)(Devolution)
Privatization (Government Privatization (Government Business) Business)
Substitution (Government Substitution (Government PVOs) PVOs)
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New Governance (Strategic Alliances)New Governance (Strategic Alliances)
Collaboration (Government + NGOs)Collaboration (Government + NGOs)
Partnering (Government + Business)Partnering (Government + Business)
Convergence (NGOs Convergence (NGOs Business) Business)
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Conventional Sector x Conventional Sector x RevenueRevenue
TaxesTaxes CommerceCommerce GiftsGifts
PublicPublic
SectorSectorGovernmenGovernmen
tt
PrivatePrivate
SectorSectorFirmsFirms
VoluntarVoluntaryy
SectorSector
Non-ProfitNon-Profit
OrganizationOrganizationss
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FirmsFirms
TaxesTaxes CommerceCommerce GiftsGifts
PublicPublic
SectorSectorGovernmenGovernmen
ttpartnershipspartnerships
PrivatePrivate
SectorSectorcontractscontracts FirmsFirms affiliationsaffiliations
VoluntarVoluntaryy
SectorSector
sponsorshipssponsorshipsNon-ProfitNon-Profit
OrganizationOrganizationss
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GovernmentGovernment
TaxesTaxes CommerceCommerce GiftsGifts
PublicPublic
SectorSectorGovernmenGovernmen
ttasset salesasset sales grantsgrants
PrivatePrivate
SectorSector
procuremeprocurementnt
contractscontractsFirmsFirms subsidiessubsidies
VoluntarVoluntaryy
SectorSector
serviceservice
contractscontractsNon-ProfitNon-Profit
OrganizationOrganizationss
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NonprofitsNonprofits
TaxesTaxes CommerceCommerce GiftsGifts
PublicPublic
SectorSectorGovernmenGovernmen
ttgrant grant
proposalsproposals
PrivatePrivate
SectorSectorFirmsFirms campaignscampaigns
VoluntarVoluntaryy
SectorSector
lobbyinglobbying brandingbrandingNon-ProfitNon-Profit
OrganizationOrganizationss
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The MBA ChecklistThe MBA Checklist
What is your mission, goals and affiliations?What is your mission, goals and affiliations?
What do you hope to gain through the What do you hope to gain through the partnership? What are you willing to partnership? What are you willing to forego?forego?
What are you willing to contribute? What What are you willing to contribute? What are you not willing to contribute?are you not willing to contribute?
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What degree of autonomy are you willing to What degree of autonomy are you willing to give up?give up?
Will management support and reward Will management support and reward collaboration and partnership?collaboration and partnership?
What are your non-negotiables? What do What are your non-negotiables? What do
you fear most about collaboration and you fear most about collaboration and partnership?partnership?
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Relationship IssuesRelationship Issues
Shirking Shirking ? ? Self-Seeking Self-Seeking Trust Trust
ObstaclesObstacles Suspicions or preconceived notions of the Suspicions or preconceived notions of the
other other No history of working togetherNo history of working together Poor communicationPoor communication ReputationReputation
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Leadership IssuesLeadership Issues
Encouraging collaborationEncouraging collaboration Nurturing versus controllingNurturing versus controlling Persistence and enduring commitmentPersistence and enduring commitment
ObstaclesObstacles
Lack of commitmentLack of commitment Opposition from withinOpposition from within Few shared goalsFew shared goals Lack of adequate planning and integrated supportLack of adequate planning and integrated support Inability to institutionalize trust and confidenceInability to institutionalize trust and confidence
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Who’s In and Who’s NotProcess Partners: 132 Organizations
56% Statewide (have Texas in their name)
8% Academic Orgs.
~6% Nonprofit Community Orgs.
<1% For-profit Organizations
Work Groups: 12 with 24 co-chairs
~50% Statewide
16% Academic Orgs.
<3% Nonprofit Community
0% For-profit Organizations
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National Public Health National Public Health Performance ProgramPerformance Program
Categorical RepresentationCategorical RepresentationCommunity OrganizationsCommunity Organizations
Local Businesses and EmployersLocal Businesses and Employers
Neighborhood OrganizationsNeighborhood Organizations
Faith InstitutionsFaith Institutions
Transportation ProvidersTransportation Providers
Civic OrganizationsCivic Organizations
Educational InstitutionsEducational Institutions
Public Safety OrganizationsPublic Safety Organizations
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CBPR is a collaborative research approach that is designed to ensure and establish structures for participation by communities affected by the issue being studied, representatives of organizations, and researchers to improve health and well-being through taking action, including social change.
To expand this definition, we conclude that CBPR emphasizes:
(1) co-learning about issues of concern and reciprocal transfer of expertise;
(2) sharing of decisionmaking power; and (3) mutual ownership of the products and
processes of research.
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A Mid-Course AdvisoryA Mid-Course Advisory
Pursue SymmetryPursue Symmetry Forget Public v. PrivateForget Public v. Private Cultivate Unlikely PartnersCultivate Unlikely Partners Trust SubsidiarityTrust Subsidiarity Nest the RestNest the Rest
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A Final NoteA Final Note
““We have found that there are many ways We have found that there are many ways to achieve partnership…There is no ideal to achieve partnership…There is no ideal partner or partnership arrangement. partner or partnership arrangement.
Successful building of partnerships requires Successful building of partnerships requires an open and proactive spirit. The craft an open and proactive spirit. The craft and tactics can be learned.”and tactics can be learned.”
-- Soros Foundation-- Soros Foundation