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February 19, 2002

# peer-to-peer mentoring program

On February 19, 2002, the Community Access Program's new Peer-to-Peer
Mentoring program was launched during a technical assistance call that
brought together CAP grantees and presenters from the Georgia Health
Policy Center.

Dennis Wagner of HRSA began the call with his thoughts on peer
mentoring. Mr. Wagner conveyed two assertions and two requests for the
CAP community:

Assertions

1.  The individuals who have the knowledge and expertise to increase
    access to health care and improve health status already exist within
    the CAP community. Many national experts are already CAP grantees.

2.  Peer mentors do not just bring knowledge and expertise to the
    collaboratives they are assisting, they bring the sure certainty
    that "it can be done", because they've already done it or are doing
    it. That power is a mentor's most valuable asset. It removes the
    "what ifs" for a collaborative that is just beginning the process.

Requests

1.  Mentors should go beyond the role of subject matter expert or
    professional. A mentor's spirit should enjoin the community and take
    part in the results. Also, a mentor should enter the relationship
    with the intention to stay in it for the long haul.

2.  Peer mentors should get comfortable with the models and language
    used in the CAP program. They should work closely with CAP team
    members, especially Audrey Smolkin, to step into the role of
    national leaders in both formal and informal ways.

What is Peer Mentoring?

Karen Minyard of the Georgia Health Policy Center joined the call to
discuss the concept of peer mentoring in general. She presented a
historical definition of mentors as those who "gently guide and nurture
the growth of others in various stages of development." The following
list details characteristics of an effective mentor:

-   Humility

-   Self-Acceptance

-   Kindness

-   Attentiveness

-   Integrity

-   Non-Judgment

-   Trustfulness

-   Perseverance

-   Patience

-   Simplicity

-   Guidance

-   Nurturing

Ms. Minyard emphasized the importance of listening. Listening
attentively to others, regardless of their status or position, is an
important trait of a good mentor. Learning and teaching should be
exchanged gladly with mutual appreciation. Guidance should involve
little intervention, no manipulation, and no coercion or imposed views.
Peer mentors should suggest choices while allowing mentees to build
personal initiatives. This allows mentees to benefit from the experience
of creating or achieving something on their own.

In an ideal world, peer-to-peer mentoring would always lead to a
long-term relationship. However, this may or may not occur. Both the
mentor and the mentee should enter the relationship with realistic
expectations. It would be most helpful for a peer mentor to offer
assistance in the context of the bigger picture, in the event that the
relationship does not continue.

Effective Peer Mentoring

Tina Anderson Smith from the Georgia Health Policy Center joined the
call next to discuss peer mentoring in greater detail. To prepare for
this particular call, Ms. Smith spoke with several individuals about the
reasons they chose to participate in peer mentoring. Most people said
they wanted to help other communities grow faster, and help them avoid
having to reinvent the wheel. All of the participants she spoke to said
they developed new energy from helping others.

Ms. Smith emphasized the fact that everyone has skills to offer. Several
people told her they wanted to help others, but weren't sure what help
they could provide. She encouraged call participants to think carefully
about those personal and organizational skills they take for granted
that might be useful to other grantees.

Two types of assistance are typically offered in a peer-mentoring
situation:

-   ***Organizational Development***: Often referred to as "the basics",
    this type of assistance can include answering questions such as how
    one gets the right people to the table, and how to engage effective
    partners.

-   ***Program Development***: Referred to as "the mechanics", this type
    of assistance involves answering more specific how-to or technical
    questions, such as how to improve access to pharmaceuticals.

Tips for Being an Effective Peer Mentor

Ms. Smith provided the following advice for potential mentors:

-   Do not impose your own personal approach on another community.
    Instead, help broaden their approach by offering your expertise
    according to their plan.

-   Help mentees find their own wisdom by asking forward-thinking
    questions.

-   Provide guidance and support through nurturing as opposed to
    leadership.

-   Ensure that the information you provide to your mentee is truly
    valuable and useful to them.

-   Try to tailor the work you're doing to your mentee's specific
    circumstance.

-   Be open to learning from those you're trying to help.

-   Be an excellent LISTENER.

-   Be creative and honest and treat others with respect.

-   Be practical and logical.

-   Make your role as a mentor a priority, and be responsive to the
    needs of the community you're trying to help.

-   Try to create an effective message.

-   Don't have a personal or institutional agenda. Be helpful without
    being prescriptive.

-   Understand the impact of what you say. Keep in mind that your
    audience may take what you say very literally.

-   Try to remain neutral and stay out of political environments. Try
    not to offend.

-   Be REAL. Don't get hung up on being an expert and forget to be
    human.

-   Share your pitfalls as well as your accomplishments. Let others
    learn from your mistakes.

-   Be concrete about your outcomes, whether with statistics, graphs, or
    stories.

-   Talk about your relationships.

-   Compliment your partners on what they've done well so far. You may
    see successes they cannot see for themselves.

Recommended Process for Peer Mentors

Ms. Smith recommended the following process for peer mentors approaching
a new relationship:

1.  Request detailed information about the peer program.

2.  Provide a general overview of your own initiative.

3.  Help your mentee get very specific about their needs and requests
    for assistance.

4.  Make offers about specific ways you can help and include any time
    limitations.

5.  Determine the most appropriate and cost-effective vehicle for
    transferring information, whether it be via phone, email, or site
    visits.

6.  Prepare and organize all relevant information.

7.  ALWAYS follow-through with the commitments you make.

8.  Check to see if your mentee's needs were effectively met and
    determine whether there are any outstanding needs.

9.  Complete an evaluation of the peer learning activity to identify
    opportunities for improvements in the future.

A Peer Mentor's Experience

Alan McKenzie, CEO of Buncombe County CARES, joined the call to discuss
his personal experience as a peer mentor. The Buncombe County
collaborative, located in Asheville, North Carolina, has been very
successful in establishing a coordinated system of care for virtually
all uninsured residents. Partners have experienced a remarkable return
on investment since implementing their system, enabling them to care for
more patients with fewer resources. This success story has led to
numerous requests for assistance from other collaboratives.

McKenzie spoke openly about how his mentoring experience developed over
time. His first experience was characterized by an attempt to "force"
Buncombe's model onto a mentee's unique situation. Acknowledging an
unsuccessful first attempt at mentoring, McKenzie was determined to
learn from his experience as he responded to subsequent requests for
assistance based on his program's success. He learned the importance of
continual dialogue -- asking effective questions, listening carefully to
mentee responses, and encouraging mentees to extract applicable lessons
from the Buncombe model to apply to their communities' unique
environments. He modified his presentation of the Buncombe model to
consolidate key program parameters and tell Buncombe's story from
multiple perspectives, both qualitative and quantitative, that
anticipated the information needs of different collaboratives. Through
effective dialog with these mentees, McKenzie found he was able, not
only to add to his program's knowledge base, but to create supporting
documentation so effective that at least one collaborative has used it
to successfully tailor the Buncombe model to their community needs with
little direct interaction with McKenzie.

McKenzie emphasized that learning from mistakes made in early mentoring
efforts inevitably strengthens mentoring muscle for subsequent efforts.
He noted that the personal experience of being a peer mentor is its own
reward and well worth the time it takes to help a peer community. The
knowledge that your program's success can be used to help others and, in
the process, enhance your own understanding through effective dialogue
only enhances the personal benefits of peer mentoring.

Mr. McKenzie made the following additional points during the call:

-   While certain models may be adopted by communities, they will always
    be adapted to local circumstances to varying degrees. Every
    community is unique, and every model may not fit every community.

-   A mentor's goal should be to accelerate learning among members of
    the mentee community, and to do so as efficiently and effectively as
    possible.

-   Sometimes just telling a mentee your program's story, backing off,
    and letting them run with it is the best approach.

-   Giving mentees more information than they ask for may cause
    information overload and do more harm than good. However, sometimes
    you have to encourage communities to challenge preconceptions and
    perceptions of potential partners.

-   Understand and acknowledge that what was best for your community may
    not be best for your mentee's current objectives.

A Peer Mentee's Experience

Ted Hanley, Executive Director of the Jesse Tree in Galveston, Texas,
joined the call to speak to grantees about his experience as a mentee.
Mr. Hanley discussed how peer mentors worked with Jesse Tree partners,
encouraging them to think globally, to standardize program information,
and to consider various combinations of relevant models they could
tailor to their unique program needs. Mr. Hanley noted that their
mentors worked to understand their requirements, providing suggestions
and affirmation based on their own experiences, yet maintained a neutral
posture than encouraged them to set their own program planning
parameters.

Tips for Being an Effective Mentee

Tina Anderson Smith offered the following comments to potential mentees:

-   Be sure to request the right information at the right time.
    Carefully consider the appropriate time to ask for help in light of
    your program's ability in terms of time and resources required to
    take advantage of the assistance you request.

-   Be as specific as possible about your program's needs.

-   Be respectful of your mentor's time and realistic about the amount
    and type of assistance you can expect.

-   Resist becoming overly dependent on your mentor, and take the
    initiative to continue working on your own. Over-reliance on your
    mentor's input may put a strain on your relationship as well as the
    time available to provide assistance.

Recommended Process for Mentees

Ms. Smith provided the following recommended process for mentees
approaching a new peer mentoring relationship:

1.  Prepare a written summary of your initiative for your mentor. Make
    sure it includes goals, scope, resources, challenges, etc.

2.  Clarify your request by determining what you want to accomplish,
    what strengths and weaknesses you have, and what you think is the
    next step for your program.

3.  Work with others to find the right mentor match. Take advantage of
    CAP's Peer-to-Peer Mentoring Program, which provides matching
    services.

4.  Clarify the amount and type of assistance being offered and what
    your mentor is willing and able to share with you. Keep in mind that
    some resources are copyrighted, which may constrain your mentor's
    ability to share them fully with your program.

5.  Clarify your community's role in your peer mentor relationship.

6.  Follow through on your obligations and be available to receive
    assistance when it's offered to you.

7.  Provide feedback to your mentor so they know they're being helpful.
    Keep them updated on the outcomes that result from their assistance.
    Remember to say "thank you"!

8.  Evaluate the experience for future reference and share your success
    with the CAP Community.

How CAP's Peer-to-Peer Mentoring Program Will Work

CAP representatives will use information from grantees' six-month
reports and the Grantee Compendium to attempt to match prospective peer
mentoring partners. However, giving or receiving mentoring services will
be expedited considerably for those grantees who take the time to
complete CAP's Mentoring Program forms. To receive forms, please contact
Audrey Smolkin at asmolkin@hrsa.gov, or visit the CAP web site at
http://www.capcommunity.hrsa.gov. The information generated to support
this initiative will be housed in a database that may be made available
on the web site in the near future.

Funds for providing grantee mentoring assistance will be taken from
respective grantee technical assistance funds. Collaboratives interested
in participating in the program as mentees who lack the required
technical assistance funds are encouraged to contact Ms. Smolkin to
identify alternative funding sources. There is no cost to prospective
mentors who offer assistance.

Grantees requesting assistance should be *very* *specific* when
describing the help they need. Simply saying "I need help with MIS" is
not clear enough. Mentors are also asked to be specific about the
assistance they are willing to offer and to provide resumes for each
person on their team that will be available to offer assistance. Be sure
to mention any limitations on time or other resources. For example,
although site visits can be mutually beneficial to mentors and mentees,
they are not required or always necessary. Grantees who wish to limit
their participation to phone calls, emails, or even a single TA call,
should note such constraints when completing their form.

Conclusion

Clearly, the Peer Mentoring experience can benefit both mentors and
mentees. All grantees are encouraged to review their programs for
strengths and weaknesses to determine if they have something to offer or
gain from their CAP colleagues.

Further information about the CAP Peer-to-Peer Mentoring Program,
including program forms and the briefing documents distributed prior to
this call, is available from Audrey Smolkin at asmolkin@hrsa.gov.