SUCCESSION PLANNING FOR PRIMARY CARE ASSOCIATIONS

SUCCESSION PLANNING FOR PRIMARY CARE ASSOCIATIONS

A “HOW TO” GUIDE TO MANAGING PLANNED AND

UNPLANNED CEO DEPARTURES

Dr. Stuart Meyers, PresidentThe Meyers Group, Executive Search Consultants

This publication was made possible by grant number U30CS16089 from the Health Resources and Services Administration, Bureau of Primary Health Care. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the HRSA.

Table of Contents

Overview ...........................................................................................................................................................1

Defining Succession Planning ............................................................................................................................3

Succession Planning for a PCA ..........................................................................................................................4

How to Get Started ............................................................................................................................................6

Succession Planning Checklist ...........................................................................................................................8

Planned CEO Departure ...................................................................................................................................9

Emergency CEO Departure .............................................................................................................................15

Extended CEO Departure ...............................................................................................................................16

Sudden and Unexpected CEO Departure ........................................................................................................20

Departure Management and Communications ................................................................................................24

Onboarding Process for New CEO ..................................................................................................................26

Conclusion ......................................................................................................................................................27

Appendix

Sample Core Competencies .............................................................................................................................28

Using a Search Firm .........................................................................................................................................29

Emotional Intelligence Overview .....................................................................................................................31

Sample Interview Questions .............................................................................................................................32

Candidate Rating Scale ....................................................................................................................................34

1

Succession Planning for Primary Care Associations (PCAs) is critical to providing effective services to Health Centers, particularly at this critical moment in our rapidly changing environment of health reform. Given that the Board of Directors is responsible for the oversight of its CEO and the current and future effectiveness of the PCA in its service to Health Centers, It therefore falls to the Board to be certain a process is in place for assuring the smooth succession whether the CEO’s departure is planned or unanticipated. PCA Boards must maintain the momentum of the organization via a seamless transition to a new CEO, and is responsible for the approval and implementation of the succession plan and processes.

Similarly, one of the critical functions of the CEO is to assure that his or her key executive and management positions are properly filled, and that thoughtful Succession Planning for those positions is in place as well. This responsibility includes, among other tasks: assessing the current and future management needs of the organization; assessing the talent available to meet those needs; and, subsequently filling the gaps when the need arises. These assessments are always considered in context of the PCA’s business plan or strategic direction, and should be an ongoing part of the culture of the PCA. The responsibility for ensuring that both a Strategic Plan and Succession Plan are in place starts at the top with the Board of Directors.

“Succession” does not just mean replacing bodies in a box on a chart. Each PCA has made its culture the cornerstone of its operations: the mission, vision, and values ARE the organization. Subsequently, placing any new executive into a PCA is done with the full belief that this individual’s values and management style are consistent with those already in place or desired by the Board. The aim of this Guidebook is to encourage any Board and its search committee to recognize that the “fit” between a new CEO and the organization is as important as the new CEOs capabilities.

This document was created to support a Board and CEO as they discharge their duties related to the continuity of leadership, management and culture at the PCA. The document focuses primarily on the succession of the CEO. However, additional tasks are delineated for developing the second tier of management, including a more thorough assessment of talent needs and availability. This is particularly important given our dynamic, complex health care environment, and so it is incumbent upon the CEO and Board of Directors to be

confident that the PCA has a team in place prepared to support the health centers in their state/region and ensure they are all competitive in this “new world”.

Finally, it must be clearly stated; PCAs are uniquely different from health centers in a number of ways, both in terms of function and purpose as well as the traditional makeup and backgrounds of board members. As a result, the desired skills for an effective PCA CEO are dramatically different than that of a health center’s Chief Executive. This guide will comment on these differences and help PCA Board members recognize the importance of functioning with a different perspective than they do when acting as a CEO in their own organizations.

When a CEO’s departure is planned and expected, this Guide will:

• Provide a guide for PCA Boards and CEOs to develop a “user friendly” approach to creating a Succession Plan one, two, and three years in advance of the planned departure of the CEO. It will delineate the rationale behind engaging the Board and all relevant stakeholders in developing a Succession Plan.

• Assist the PCA to ensure that its business plan is communicated to and understood by the CEO’s successor;

• Assist the PCA Board and departing CEO in outlining a search and selection process that will culminate in the selection of an outstanding successor and smooth transition;

• Provide a sample “check list” for the outgoing CEO to prepare for his/her Board and successor; and,

• Describe an effective “on-boarding” process for the new CEO.

When the PCA Board is faced with the need for “crisis Succession Planning,” this tool-kit will provide step-by-step guidance in:

• Developing the processes needed to quickly identify, name, and support an Interim CEO immediately after an unexpected departure.

• Creating a plan to ensure the most critical CEO functions are carried out, such as:

I. Overview

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1. Attainment of corporate goals and strategic plan continuation

2. Fiscal and operational oversight3. Establishment and maintenance of

relationships with PCA members, elected officials that impact on public policy issues, and external relationships.

4. Communications to include those with the Board of Directors, executive staff, other staff, and key players external to the organization.

5. Approval of policies and all personnel actions; supervision of executive staff and other employees.

• Ensuring the transition is managed to assure staff remain focused, feel supported, are productive, and morale remains high during the period of transition

• Ensuring that while the business of providing PCA services continues, a permanent succession plan is implemented by the Board of Directors so all internal and external stakeholders are able to look toward the future with confidence

• Developing the appropriate “message” acknowledging a change at the top, but conveying an upbeat and positive future briefly describing how business will be conducted as the organization goes through a thoughtful process to hire a permanent CEO.

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Simply put, Succession Planning is the process in which an organization develops a thoughtful, comprehensive and detailed method to ensure the well-being and success of that organization as key leadership personnel leave their positions. In a non-profit setting, it is the fiduciary responsibility of the Board of Directors and their CEO to assure the mission, values, and success of that organization continues. Leadership change can be an anxiety provoking event for any organization and all of its “stakeholders,” including clients, employees, community leaders, policy makers, and Boards, particularly when change is sudden and unexpected. It is the non-profit Board’s responsibility to ensure all stakeholders remain confident about the future of the organization, that it can continue to function effectively and that a transition of leadership is accomplished smoothly.

Further, it is the Board’s responsibility to ensure its sole employee, the CEO, has a comparable succession plan in place for all other leadership positions in the PCA. Change of any kind can upset the flow and rhythm of how an organization functions and succeeds at fulfilling its mission. Therefore, it is incumbent upon the Board and CEO to reduce the difficulties that can ensue. Boards of Directors must fully embrace their responsibilities by understanding that vacancies in any leadership role can bring about confusion, conflict, struggles for control, feelings of loss, career uncertainly for others, and instability.

Change also creates opportunityBoards should also recognize that leadership change is also an opportunity for that Board and the organization. It is an opportunity for that Board to demonstrate its value, its commitment to all of its stakeholders, its confidence in the future of the organization, and its recognition of the importance of the human capital within the organization. This is best accomplished when that organization has a well-defined and clearly documented methodology for filling vacant positions particularly when stakeholders who are invested in the future of the organization also have an opportunity to have input into the process of Succession Planning. It is also an opportunity for a Board to re-evaluate the short and long term goals of the organization in order to determine if a new direction is needed. This will likely impact the “profile” that will be developed identifying the skill sets and experiences required in a new CEO. In short, how a Board plans for and manages this transition will have a lasting effect on all concerned.

Thoughtful Succession Planning provides a methodology ensuring the strategic needs of an organization are met, and there is alignment of employee skill sets and capabilities with the specific goals and strategic direction of the organization. It is the Board’s responsibility to ensure that its CEO recognizes this by completing a periodic assessment of the job requirements needed based on marketplace demands and external changes taking place effecting the stability and success of the membership.

Thoughtful Succession Planning at all levels of the organization gives a Board the opportunity to strengthen its relationships and credibility with senior level staff, which in turn provides for long term confidence in the organization by all stakeholders. It is also reassuring to employees (and their families), clients, community leaders, vendors, and policy makers to know that the organization they depend upon is “in control” of its future. In fact, ideally a good plan will allow for a symbolic visible “passing of the torch” from its current CEO to his/her successor. If the outgoing CEO is well respected, this symbolic blessing of the next CEO is extraordinarily reassuring to those whose lives will be affected by a change at the top.

Sudden Changes at the TopBut, as the saying goes, “stuff happens”. The reality is that even with thoughtful planning, developments take place resulting in the sudden departure of the CEO or one or more of key staff. As suggested earlier, any change in leadership can have an unsettling effect on all concerned. This is particularly true if that change leads to sadness, feelings of loss, concerns about increased workload, fears created due to the firing of senior executive without notice, or a vacuum of leadership that leaves staff confused and uneasy. This, in turn, can easily lead to turnover, internal struggles for “power”, and a loss of momentum in terms of the strategic direction of the organization. As a result, Succession Planning is also ensuring that all parties understand that there might be times when a transition is sudden and unexpected, and “all will be ok” because the Board and its CEO have taken the responsibility to cover all eventualities.

Succession Planning also provides an opportunity to send a powerful message to the new CEO, whether their predecessor’s departure was planned or unplanned. It says the new CEO will be working with and for a Board that is invested in the organization’s future and current staff.

II. Let’s Define Succession Planning

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The process of doing Succession Planning for a PCA CEO significantly differs from the processes involved in Succession Planning and recruitment of a CEO for a health center. While the ultimate “consumers” of a CEO’s leadership in both a PCA and health centers are the patients being served, the success of a CEO in each setting will be measured by the degree to which they possess the unique skills related to each setting. For these reasons, it would be helpful to articulate these differences as an Association board goes about the business of Succession Planning.

The Differences1. Health center boards are volunteers whose roles

outside of the health center are typically unrelated to the services being provided by the Center. Board members of Primary Care Associations have obviously volunteered to serve on such a Board, but their full time focus remains on their own health center in their own communities and the provision of primary care services to patients. Inherent in this difference is an understanding that the future success of their own Center is in part affected by the success of the PCA and its ability to provide services and represent its members on a broad, statewide basis.

2. Health center board members come from a wide variety of backgrounds and are involved in non-health center related jobs and activities, and are not typically CEOs of their own organizations. On the other hand, PCA Board members (usually) come to the table as CEOs themselves, accustomed to functioning as Executives whose opinions are typically the single most influential recommendations that effect decisions. On the other hand, a PCA CEO has no line authority to change anything within the structure and performance of a health center. Instead, through its training and technical assistance capabilities, a PCA can try to influence improvements at the health center level.

3. Health center board members have joined their Boards because of a commitment they have made to their own communities and people in need of services. Their stakeholders are local citizens, elected officials, other local health care entities and local organizations, all of whom are invested in the futures of their own communities. A PCA’s mission is typically to

support a large number of health centers with the recognition that health center’s own community and the and organization is different in size, culture, demographics, and need. It is therefore essential that the PCA be effective at providing support, training, and technical assistance to all health centers they represent.

4. The successful CEO of a health center understands that the organization’s success is largely a function of the degree to which their leadership impacts the quality of work done by staff and providers, and the support they receive from their Boards to serve their own communities. Inherent in this notion is recognition that the health center CEO is “the” pivotal ingredient to assure the fulfillment of the mission of that Center. Conversely, the PCA CEO’s leadership requires that they are capable of bringing a wide variety of external constituents together to impact state-wide matters of concern to all members. PCA membership consists of Centers from large metropolitan areas, rural areas, budgets that might range from $1m to $50m with anywhere from 1 site to dozens of sites, and staff sizes ranging from a few to over 200 employees. As a result, the “culture” of each health center, their goals and objectives, the financial stability and longevity of that organization and its CEO, and the demographics of each organization’s community and staffing will vary. It is the PCA’s CEO job to bring this incredibly diverse group of organizations together for a common set of goals while respecting that each member may have slightly different goals and expectations.

5. An important function of the health center CEO is to play a leadership role in the public policy and advocacy arena in their communities and at a state level. The PCA CEO must bring together of a diverse group of members in order to shape state and national public policy on behalf of all members. Inherent in this notion is the recognition that the PCA CEO must be someone with skills related specifically to finding common ground on behalf of this diverse group of stakeholders.

6. Simply put, a PCA is not a health center. One of the common mistakes made by PCA boards when creating a job description, considering resumes and

III. Succession Planning for a Primary Care Association vs. a Health Center

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interviewing candidates is to use the same or very similar criteria used to hire a health center CEO. It is certainly logical for a health center CEO to assume that the CEO of the PCA should have strong, hands-on experience running a health center or similar provider of care. To that point, there certainly have been many examples of health center executives making the successful transition to PCA CEO. However, the day-to-day responsibilities of a PCA CEO have little in common with a health center CEO and require a very different skill set.

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As Steven Covey reminds us, it is always best to “begin with the end in mind”. With this understanding, it is advisable to consider the following issues in developing a Succession Plan, whether the transition of the CEO is planned or unplanned.

Recognize the needA PCA Board of Directors must fully appreciate the fiduciary responsibility they have to the patients served by health centers in their state/region, PCA staff, and health center employees. The Board must also recognize that the PCA CEO shares that responsibility and be committed to executing the plans and intentions approved by the Board. The place for a Board and its CEO to begin is wherever they happen to be at this moment in time. This begins with communications. This is the time when the Board has the responsibility to either reaffirm the current course and direction of the PCA, or to make some modifications that will lead to the development of a CEO Job Description or Profile that differs from the current one.

“Don’t just do as I say…but do as I do”A Board will likely only reach a conclusion that its PCA have a well-developed Succession Plan if they also believe such a plan should exist at their own health center. While this is a subject somewhat distinct from the focus of this Guidebook, it would be difficult for a PCA Board to have open and honest discussions if they didn’t also agree their own health centers should have a plan in place. This begins with the Board having an open and honest dialogue about the criticality of having a strategic plan to anticipate all possible scenarios. Similarly, a Board’s credibility is further enhanced if it has also put a Succession Plan in place for itself, and not just for its CEO and his/her staff.

The importance of communicationsA PCA Board and CEO need to be transparent and honest about their intentions and rationale. Ideally, this dialogue must take place amongst a Board of Directors in an atmosphere of trust and safety, and the same is true with the discussions that need to take place with their CEO. Too often CEOs function in a culture of anxiety over job security, which in turn leads to resistance about the development of a Succession Plan.

Dr. Kerry Sulkowicz, a well-regarded consultant to organizations and their CEOs about the psychology of business said it best: “The boss’s failure to groom an internal successor

may point to a more difficult aspect of the problem. Some CEOs have a hard time acknowledging their dispensability (and their mortality) or are reluctant to have anyone near them who could eventually take their place. The board may have colluded in sustaining the perception of utter dependence on his presence. All of this does the organization a disservice and makes the CEO’s retirement bittersweet rather than a cause for celebration.” The way to address these dynamics is to first recognize they exist, and then to have honest discussions about these issues if the Board truly desires to put a Succession Plan in place given their fiduciary responsibility to do so. Addressing this issue openly and directly is one example of reinforcing a culture that would be attractive to potential new CEOs and appreciated by other staff.

The CEO as an active participantIt would be best if the Succession Planning dialogue began with the Executive Committee of the Board. Once consensus is reached about the need to have a plan in place or refine an existing plan, it is then necessary to receive the full blessing of the entire Board. It is also best if the CEO was fully cognizant of these discussions taking place, participating in these discussions, and fully supporting the Board’s actions. In fact, having the CEO embrace the need for a well -defined Succession Plan is paramount. In an ideal world, having such a plan for the CEO is only the beginning, for this person is then responsible for the development of similar plans with his/her management team in order to ensure the organization remains vital and successful even with the departure of the CEO.

The Primary Care Association as a “learning community” It is important to recognize that Succession Plans for both planned and unplanned departures should be committed to the development of current staff and to identify potential internal candidates should the need arise. In an unexpected departure (more on this later), the Board needs to know that a current staff member has been identified and has been prepared to step into the role on an interim basis.

In a planned departure, it is also appropriate to expect there might be internal candidates who might apply, and who have been prepared to move on to the next level of the organization. This does not presume this individual is guaranteed the position on a permanent basis, but such a plan provides for a continuity of leadership and continued progress toward meeting organizational goals. It also helps the organization

IV. How to Get Started

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avoid the kind of uncertainty and anxiety that comes with a departure of a CEO.

For development of potential internal candidates to take place in a responsible way, there needs to be honest communications about intentions and purposes between the Board and CEO, and CEO and management team. Ralph Nader said it best: “I start with the premise that the function of leadership is to produce more leaders, not more followers”. And while Jack Welch, former CEO of General Electric, functioned in a very different world than health centers and PCAs, lessons learned from such a successful leader who developed other leaders should be considered. Specifically: “From now on, choosing my successor is the most important decision I’ll make.” What makes this concept most appealing is that it recognizes that most employees are motivated by opportunities to grow, advancement, and being able to make a contribution. Organizations can begin to feel like a “learning community” when a Board and its leadership commit to staff development, cross training, and a place where opportunity for advancement exists.

Succession Planning as Part of Strategic PlanningAs suggested earlier, an integral part of an effective Succession Plan is dependent upon an organization having an approved Strategic Plan outlining where it wants to be in the next several years. Having these objectives firmly in mind are critical as a Board begins a process of recruiting its new CEO whose skills and experiences are compatible with the future needs of the organization. The Strategic Plan must also be in mind when a identifying who would be best prepared to step into the CEO role on an interim basis at a time of an unexpected departure.

It is understood that the health care world is a dynamic and rapidly changing environment and the needs of an organization in 3 - 5 years might be different than those in the next 12 months. This kind of uncertainty must not stop a Board from having a plan in place based on its current sense of where their marketplace might be going. Rather, it simply reminds us that our next CEO must possess an ability to be flexible, adaptable, and capable of leading with “both feet planted firmly in mid-air.” Should such a Strategic Plan or business plan not be in place or be in need of updating, the Board of Directors needs to return to the table to develop/enhance that plan while simultaneously putting in place a Succession Plan in the event of a sudden departure of the CEO.

Succession Planning has a Cost in Time and MoneyIt would be naïve to assume that the development of a durable Succession Plan would be free of cost, whether it is the cost of time given by a volunteer Board, or actual dollars spent on taking an organization through a Succession Planning process.

It would also be unrealistic to assume that developing succession plans at other levels of the organization would be

free of cost. The development of a true “learning community” where staff is given opportunities to further develop skill sets and potentially progress into another position is a time consuming and costly commitment for the organization. However, the process begins at the top, and depending upon circumstances and resources, the message needs to be clear that the organization values career development while it commits to the sustainability and continuity of the organization. Having a commitment to Succession Planning at other levels of the organization allows for the development of a framework that encourages the growth of other managers in ways that meet the strategic needs of the organization. It also gives the Board and Management ongoing responsibility to look practically at their current roles and responsibilities based on marketplace changes, and reinforces the value of open, honest, and ongoing communications between the Board and CEO and the CEO and management.

It would also be fair to acknowledge that the failure of a Board (and CEO) to have a succession plan also has a cost. It is clear to all executives that the loss of personnel who have critical responsibilities will impact the work loads and productivity of staff having to assume those responsibilities. The workload falling on the shoulders of a Board without a Succession Plan in place should its CEO position suddenly become vacant would be dramatic.

There are direct and indirect costs of doing Succession Planning for both the PCA and the health centers it serves. A thoughtful planning process takes time and energy, particularly if the organization must also update its current Strategic Plan and brings in outside consultation to assist. If the PCA is truly committed to a staff development program that prepares the organization for its future needs or sudden departures, it is important to insure each staff member’s growth needs are identified, career objectives are clear, and time be allocated to allow for additional training or development.

“Whose Association is this, anyway?”It is essential that the Board maintain its focus on the PCA’s needs while developing a Succession Planning process, not prioritizing the personal needs and wishes of the CEO. Both are critically important, but the definition of fiduciary in the context of a not-for-profit Board implies that the Board’s primary responsibility is to the well-being and success of the organization, and ultimately to the patients being served. Remembering Covey’s recommendation about “beginning with the end in mind,” if the PCA Board were to follow the steps outlined, the Board would set the stage for a process that develops a well-defined written Succession Plan that can be put into place whether the CEO departure is planned or unexpected.

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In order for a PCA to be prepared for any scenario in which the CEO departs, it should accomplish the following on an annual basis:

• Ongoing formal review with the CEO of current strengths, weaknesses, attributes of CEO and all staff on an annual basis; identify areas for growth and career goals of each.

• Annual Review of Business/Strategic Plan. Modify where appropriate with final Board approval with input from CEO and staff, and where appropriate external stakeholders. Goal must be “sustainability” of the PCA by relating the Strategic Plan and Vision through leadership transitions.

• Annual assessment of current resources and capabilities of staff related to current and future goals and objectives of the PCA - Identify staff person(s) capable of stepping into

leadership role with short notice on an interim basis; insure this is clearly understood, in writing, and this individual is “mentored” relative to major issues

- Identify other staff capabilities and interests by cross training or promotional opportunities

• Annual review of the culture of the organization; how it makes decisions, morale, systems and processes; team orientation; empowerment of staff;

• Ensure a written document is maintained with all critical information for the Board and Interim CEO to have the organization function smoothly; including all corporate records, key external relationships, passwords, contact information of personnel, banking and finance information, back-ups of all records and data off-site, operations manual

• Have evaluation tools to review outcomes in place as part of assessment of “health” of the organization and areas for growth

• Have consensus and clarity around priority goals and objectives at 6 month intervals; reassess and reprioritize as needed

• Ensure a plan is in place for sudden departure or leave of absence of CEO due to illness, or other departure with little or no advance notice. Such a plan identifies current priorities and assignments of duties and responsibilities

• Identify potential leaders, candidates for cross-training and promotion; maintain formal plans to continue to grow and develop the PCA’s Human Capital

• Maintain a clear plan approved by the Board of how Succession Planning would take place, be executed, and by whom.

V. A Review: Maintaining a Succession Planning Checklist for the Board and CEO

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There will be times when the CEO/CEO position becomes vacant due to retirement or other reasons that give a Board adequate time to execute the succession plan. In order to maximize the stability of the organization and allow itself ample time to select a new permanent CEO, the following assumptions need to be made:

Assumptions • It is solely the responsibility of the Board of Directors

to hire and fire the Chief Executive Officer of their Primary Care Association. It is assumed that this is clear in the organization’s by-laws as well as the mechanics involved in the selection process.

Transition CommitteeWhile it is ultimately the full Board’s responsibility to approve the selection of the CEO, most organizations will appoint a Selection or Transition Committee to lead the organization through this process. Typically it is the Executive Committee of the Board that serves in this capacity, but other members can be appointed to this Committee based on their potential contribution to the process. A committee of approximately 5 – 7 members is a productive group size in order to maximize participation and ensure that a selection process can proceed with appropriate speed. Rarely is this Committee empowered to make the final decision, but it is traditionally empowered to bring its final recommendations to the full Board. The Selection Committee Chair is usually the Board Chairperson, but may be delegated as appropriate. If possible, a Board member with Human Resources expertise should be part of the Committee as well. The Selection Committee should keep the full Board informed of progress and recommendations throughout the process.

• Soliciting input from others: Given the multitude of significant “stakeholders” having a vested interest in the outcome of a selection process, it is recommended that soliciting input of representative stakeholders can be enormously productive. However, it is not recommended that the Search Committee have non-Board members on their Committee. It is also recommended that PCA staff representatives participate in the interviewing process with finalists in order to provide input to the Selection Committee (not recommendations). This naturally includes the departing CEO when the departure is under

positive circumstances. It is important to seek the input of stakeholders such as other PCA member organizations, elected officials, community partners, and other relevant parties’ recommendations prior to the initiation of a search or hiring process. Including this “input” stage in the process allows the Board to have a reevaluation process relative to the future needs of the organization, which in turn will impact the development of the final ideal candidate Profile. Asking for external stakeholder input at the front end of a search and selection process demonstrates the PCA’s wish to have a true partnership. Such partners should certainly include all health centers in the state, elected officials, and the wide ranging expertise available from NACHC relative to public policy issues and training and technical assistance resources.

• Whose decision is it? It is rarely appropriate for non-Board participants to attempt to influence the final selection. A sharing of perspectives and areas for growth is appropriate, but not a formal recommendation to the Board as to whom to hire. This is particularly true in terms of the role played by the outgoing CEO. It is best if this person play the role of consultant to the Board prior to and during a hiring process, and then historian and Transition Guide to the new CEO once on board. • Support for the Transition Committee:

Should the Board decide for either an internal or external search, it is highly advisable to have a “confidential” PCA employee assist given how time consuming the management of this process can be. Often this is the Director of Human Resources or the Executive Assistant who already maintains confidential records for the Board. The recruitment process itself, scheduling of interviews for Board members and candidates, and record keeping requirements are all tasks that require focus and time typically beyond the ability of Board members to manage. Another task that is traditionally an important part of a selection process at the CEO level will involve the arrangement of candidate (and spouse or significant other) to visit the local community when at the final stages of interviewing.

• It’s a two way “street”: It is essential that the Board and entire organization understand that the selection

VI. When the CEO’s departure is planned

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process of a new CEO is a “two-way” evaluation process. Candidates (and their spouses/significant others) are assessing the opportunity as much as the organization is assessing the candidate. The single biggest reason why a candidate turns down a job offer at the very end of a process relates specifically to the organization’s failure to recognize that career changes for executives are typically a family decision, particularly if relocation is part of the equation. The entire recruitment and selection process must be designed with this in mind. The spouse or significant other must feel welcomed into the process, and given the opportunity to know the organization and community their partner is being asked to lead.

• Where to begin: The Selection Committee will begin with a review of the existing job description. It should be modified as appropriate in order to be consistent with the PCA’s business plan and strategic direction, with the option of adding a list of selection criteria to also be considered during the search process. These documents should be fully shared with all participants in the process.

• On our own or engage a Search Consultant?: Based on the current environment and needs of the organization, the job description, and the search criteria, the Committee will determine if there is a need to hire a consultant (e.g. Executive Search Firm) to assist with recruitment and selection process. If the Committee determines that a national search is needed, it should seek the assistance of the HR Department who can access executive search organizations experienced in recruiting executives for non-profit Associations. (See Appendix 2, page 29 for a discussion of the pros and cons of using an Executive Search Firm).

- The role of the outgoing CEO: Determine, if appropriate, whether the departing CEO should be asked to assist with any part of the process, and, if so, set parameters around this engagement. This determination will be made based on the circumstances of the CEO’s departure and the time frames that might exist prior to the CEO’s exit. Regardless of circumstance, it is never appropriate for a CEO to either pick his/her successor or even give the appearance of influencing the process that results in a final selection. This decision is solely the responsibility of the Board. For this reason, under the best of circumstances, the outgoing CEO can play the role of “historian” to final candidates by providing them with their perception of the current environment and needs for the future. The CEO should not be placed in the position of interviewing his/her successor, nor

be asked to make recommendations about the selection. Under less favorable conditions related to the CEO’s departure, it will be particularly important for the Board to establish clear boundaries relative to any role they might play.

- The need for an Interim CEO: The Board must first determine whether an Interim CEO is available from within the organization to meet the needs of the PCA and its membership. It should also ask themselves whether this person could fully assume the role of President/CEO on a permanent basis? If so, the Committee may choose to stop here, and recommend permanent appointment of the Interim to fill the vacancy. Naturally, the timing of the departure of the current CEO and degree to which the PCA has developed an existing Succession Plan will impact the decisions regarding the need for an Interim and that person’s ability to become the permanent CEO.

- Tools to be developed: If a broad search is required, the Committee should develop screening procedures and tools such as interview guidelines, candidate questionnaires, required document submissions, and determine recruitment expenses and reimbursement for candidates.

- Who should be involved in the interviewing process: The finalists should be interviewed by the full Board, based on the Search Committee’s recommendations. At the discretion of the Committee, employees, consumers and other interested community stakeholders may be given the opportunity to meet with the final candidates and provide input to the Board. It is important to be clear that input from staff and external stakeholders can be helpful as long as it is structured in a way to avoid having non-Board members making recommendations about who to hire. This participation in the final interviewing process should be distinguished from the solicitation of input from key stakeholders prior to the Search process. The objective of receiving input at an early stage shortly after the CEO’s departure has been announced is for purposes of reassessing the “profile” of the ideal next CEO based on an understanding of the PCA’s future needs and direction.

- Background checks and assessment tools: Formal background checks and references should be conducted in the process to help determine the selection. In addition, the Committee should consider the use of Assessment tools to help

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evaluate each final candidate as one additional “data point” to build into the selection process. For example, Emotional Intelligence (EQ) testing can be valuable given its high correlation with the kinds of attributes one would wish to see in a leader. Other such tools should also be considered as an option. (See Appendix 3, page 31 for EQ example.)

- Preparing for the arrival of the new CEO: The Board will develop a formal Post-appointment Executive Transition Plan, with an emphasis on the development of an “On-Boarding” plan.After the CEO selection has been made, there is still much work to ensure that new CEO has a successful beginning. The Board has made a significant investment in this new executive and the post-hire process is about making the most of this investment. The Board needs to ask:• What can we do to help our new CEO begin

on the right foot?• What can we do to structure the Board/

CEO relationship in a positive way?• What can we do to ensure we achieve the

goals we set in the planning stages of this transition for the first six – twelve months of his/her tenure?

The following “Process Summary” captures this entire process in a step by step fashion when the CEO’s departure is planned and the Board is given sufficient notice to plan for a successor. It is early in the Phase 1 “Pre-Search” activities stage that the Board will decide whether to conduct the search on their own, or to bring in a 3rd party search firm to manage the entire search process in concert with the Board.

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Process Step

Process Summary for Planned Departure, with or without Search Consultant

Activities/Action Items Start Date

Finish Date Responsible Party

Status:(Not Started, In Process,On Hold,

Behind Schedule, Complete)

Phase 1:

Pre-Executive Search Activities(over 1 – 2 month period)

Resignation notice — CEO gives notice date (ideally 6 – 12 months’ notice) CEO

Board/CEO discusses departure & timetable. Board decides whether to conduct the search themselves or bring in a 3rd party consulting firm. If Search Firm is engaged it should begin to actively participate in all activities from this moment forth and manage all facets of the search, marketing, interviews, candidate feedback, resignation and hiring process of selected CEO, all in concert with Transition Committee

Board Chair/CEO

Board appoints transition committee Board Chair

Board Chair and Transition Committee Chair hold organizing meeting; discusses Interim CEO availability depending upon circumstances; Committee makes recommendation to Board for Interim CEO if needed

Board Chair & Transition Committee

Transition committee plans departure announcement with CEO (if appropriate)

Board Chair and Transition Committee Chair

Board chair meets as appropriate with staff Board Chair and staff

Organization announces departure publicly, along with plan to succeed outgoing CEO Board Chair

Board holds strategic review and leadership planning meeting; modify goals based on strategic plan. (ideal if this plan is already in place based on strategic needs of the organization) Board Chair

Transition committee meets and drafts the following pre-search resources: Job profile (updated Job Description to be consistent with Strategic Plan Goals & Objectives)Compensation planTransition work plan (includes search plan)Search budget

Transition Committee Chair and Committee

Transition Committee presents final recommended job profile, compensation plan, transition work plan and search budget to the Board of Directors for approval


Upon Board approval Transition committee launches executive search as outlined in the transition work plan

Transition Committee Chair and the Board of Directors

13

Process Step






Executive Search Activities (over 2 – 3 month period)

Transition Committee holds check-in meeting(s) as needed (with Search Consultant if one is retained)

Transition Committee Chair & Committee

Transition Committee identifies advertising venues and places advertisements :advertisingweb postingsdirect recruiting


Transition Committee determines how to manage resumes for review


Transition Committee holds resume review meetings; and selects candidates to bring in for 1st interview

Transition Committee

Transition Committee holds round one interviews (no staff involved in Round 1); confidentiality regarding candidates is maintained

Interview Sub-Committee

Transition committee holds update & planning session with staff for Round 2


Finalists visit office and meet with staff; departing CEO (if appropriate); external stakeholders; spouse/significant other tour community. Receive input from staff & others but not recommendations

Board Chair, CEO Candidates, and staff

Executive Committee holds round two interviews and makes decision on choice

Executive Committee of the Board

Board meets to ratify selection and enter into employment agreement with new CEO Board of Directors

New CEO gives notice to current employer New CEO

14

Process Step






Phase 3:

Post -Executive Search Activities(over 3-6 month period)

Transition committee plans on-boarding process:Develops transition/onboarding checklistOrientationBuilding key relationshipsDetermine Executive’s needsFocus on retaining new CEO


Organization announces new CEO; arranges for a “passing of the torch” event when appropriate Board Chair

New CEO starts work New CEO

New CEO and board embark on orientation/post-hire process Board Chair and New CEO

CEO completes 90-day plan New CEO

Board chair engages with New CEO in 90-day check-in review Board Chair and New CEO

Executive committee conducts six-month evaluation of new CEO

Executive Committee and New CEO

Executive committee conducts 1st annual performance evaluation of new CEO


15

An emergency absence of the CEO is one expected to be less than 90 days, during which time the incumbent is not in a position to continue to effectively lead the organization (e.g. serious illness, family emergency out of the area, etc.). The Board should follow these processes:

A. The CEO, if available, with collaboration and consent of the Board should have the primary responsibility of naming a temporary Designee. It is expected that the CEO had previously developed a Succession Plan that would have prepared a staff member for this possible eventuality with Board consent. If no such internal person exists, the Board and CEO should have previously identified an external entity or person that could assume the interim leadership role in the case of an emergency. Under only the most unusual of circumstances, and only with unanimous Board consent, should a member of the Board become the Designee.

B. The Designee will be responsible for the performance of the most critical CEO functions, including:

1. Attainment of corporate goals and strategic plan continuation. The Board should prioritize the most imperative goals and tasks for the Interim CEO.

2. The maintenance of strong relationships with PCA members, particularly with respect to public policy issues

3. Fiscal, operational oversight, and risk management.

4. Maintain relationships with all PCA members

5. Maintenance of all external relationships to include partners, contracts, and agreements.

6. Communications to include the Board of Directors, executive staff, other staff, and key players external to the organization.

7. Approval of policies and all personnel actions; supervision of executive staff and other employees.

C. It is expected that routine executive management team meetings keep all executive staff fully involved and informed in all key strategic and operational aspects of the company, as is the responsibility of the CEO on a continuing basis.

D. It is expected that all executive level staff will provide full support to the Designee during the emergency period. It is also expected that the Designee will seek and utilize the expertise of all executive and administrative staff in decision making, including:

1. Consult with the Finance Director in advance of significant financial decisions or execution of written agreements.

2. Consultation with the Development, Marketing, Human Resources, and other departments.

3. Consultation with corporate counsel regarding legal/contractual matters. Will also notify Board Chairperson in the event of legal issues that might arise.

4. Upon return of President/CEO, the designee should report on significant actions taken during the President/CEO’s absence.

VII. Emergency (Unplanned) Absence of the CEO

16

A. The responsibility for appointing the long-term designee should be the Board Chair in conjunction with the Board Executive Committee, and with concurrence of the full Board. Solicitation of the CEO’s recommendation should be conducted if feasible.

B. The procedure that could be used for extended absence is as follows:

1. The internal Designee should be named or an external resource similarly identified, unless the full Board, acting upon the recommendation of the Executive Committee, determines otherwise. Typically this would be done in consultation with the President/CEO if possible.

2. Training needs, if any, must be delineated, reported to the Board by the Designee, and implementation begun.

3. The authority to act, along with exceptions and restrictions, must be delineated (noted under Emergency above).

4. If the Length of duty is known, it should be articulated to all interested parties including staff and community.

5. Other conditions, if any, should be specified to include adjustments to compensation, priorities, or activities to be conducted and/or required by the Board of Directors.

6. Under only the most unusual of circumstances, and only with unanimous Board consent, should a member of the Board become the Designee.

VIII. Extended Absence of the CEO (3 months or longer)

17

Process Step

Process Summary for Emergency/Extended CEO absenceActivities/Action Items

Start Date




Phase 1:

Pre-Executive Search Activities (over 30 day period)

Board is notified of sudden development & need for Interim CEO due to emergency circumstances CEO /Board Chair

Board/CEO (if available) discuss circumstances and possible timetable & Board decides on whether to name an internal person as interim or seek immediate assistance in identifying an external interim CEO. (having a plan in place in case of such a possibility is of enormous help to the Board)

Board Chair/CEO

Board appoints transition committee; typically the Executive Committee of the Board Board Chair

Transition Committee monitors the situation relative to the CEO’s absence, determines whether it needs to recommend a permanent successor plan of action to the full Board; if needed, seek Board support for such a plan.




Board chair meets as appropriate with staff to process its decision and plans to either appoint Interim as new CEO or begin a search process

Board Chair and staff

Organization announces departure publicly, along with plan to succeed outgoing CEO Board Chair

Board holds strategic review and leadership planning meeting; modify goals based on strategic plan. (ideal if this plan is already in place based on strategic needs of the organization) Board Chair

Transition committee meets & drafts the following pre-search resources: Job profileCompensation planTransition work plan (includes search plan)Search budget


Transition Committee presents final recommended job profile, compensation plan, transition work plan and search budget to the Board of Directors for approval


Upon Board approval Transition committee launches executive search as outlined in the transition work plan

Transition Committee Chair and the Board of Directors

18

Process Step


Start Date




Phase 2 Executive Search Activities (over 2-3 month period)

Transition Committee holds check-in meeting(s) as needed (with Search Consultant if one is retained)

Transition Committee Chair & Committee

Transition Committee identifies advertising venues and places advertisements :advertisingweb postingsdirect recruiting


Transition Committee determines how to manage resumes for review


Transition Committee holds resume review meetings; and selects candidates to bring in for 1st interview

Transition Committee

Transition Committee holds round one interviews (no staff involved in Round 1); confidentiality regarding candidates is maintained

Interview Sub-Committee

Transition committee holds update & planning session with staff for Round 2


Finalists visit office and meet with staff; departing CEO (if appropriate); spouse/significant other tour community. Receive input from staff but not recommendations

Board Chair, CEO Candidates, and staff

Executive Committee holds round two interviews and makes decision on choice

Executive Committee of the Board

Board meets to ratify selection and enter into employment agreement with new CEO Board of Directors

New CEO gives notice to current employer New CEO

19

Process Step


Start Date




Phase 3:

Post -Executive Search Activities(over 3-6 month period)

Transition committee plans on-boarding process:Develops transition/onboarding checklistOrientationBuilding key relationshipsDetermine Executive’s needsFocus on retaining new CEO


Organization announces new CEO

Board Chair

New CEO starts work New CEO

New CEO and board embark on orientation/post-hire process Board Chair and New CEO

CEO completes 90-day plan New CEO

Board chair engages with New CEO in 90-day check-in review Board Chair and New CEO

Executive committee conducts six-month evaluation of new CEO


Executive committee conducts 1st annual performance evaluation of new CEO


20

As with any organization, either the CEO and/or Board may reach a point when one or both make a decision to terminate the relationship. This development might occur due to performance related issues, legal issues, or a decision by the CEO to leave the organization for personal reasons or a professional opportunity elsewhere.

IX. Sudden and Unexpected Departure of the CEO

21

Process Step

Process Summary for Termination of CEO/Board Relationship

Activities/Action Items

Start Date




Phase 1:

Pre-Executive Search Activities

Timetable: within 30 days if possible

Board and/or CEO agree to part based on either performance, legal, or career opportunity reasons….following appropriate Board & CEO discussions

CEO/Board Chair after Board decision process

Board/CEO (if available) discuss circumstances & possible timetable; Board decides on whether to name an internal person as Interim or seek immediate assistance in identifying an external CEO). Having a plan in place in case of such a possibility of enormous help to the Board)

Board Chair/CEO

Board appoints transition committee; typically Executive Committee of Board Board Chair



Board holds strategic review and leadership planning meeting; modify goals based on strategic plan (ideal if this plan is already in place based on strategic needs of the PCA


Board holds strategic review and leadership planning meeting; modify goals based on strategic plan (ideal if this plan is already in place based on strategic needs of the PCA

Board Chair

A. Transition committee drafts the following pre-search resources: a. Job profileb. Compensation planc. Transition work plan (includes search plan)d. Search budget


B. Transition Committee holds meetings to review pre-search resource documents:a. Job profileb. Compensation planc. Transition work plan (includes search plan)d. Search budget


C. Transition Committee presents recommended job profile, compensation plan, transition work plan and search budget to the Board of Directors for approval


22

Process Step



Start Date




Phases 2 - 3same as Planned ResignationExecutive Search Activities

A. Transition Committee holds check-in meeting(s) as neededTransition Committee Chair & Committee

B. Transition Committee prepares search tools to support search process:a. Position announcementb. Resume scoring sheetc. Interview agenda and questionsd. Interviewee rating criteriae. Reference checking toolf. Sample offer letter


C. Transition Committee identifies advertising venues and places advertisements :a. advertisingb. web postingsc. direct recruiting


D. Transition Committee determines how to manage resumes for review


E. Transition Committee holds resume review meetingsTransition Committee Chair and Committee

F. Transition Committee holds round one interviews Interview Sub-Committee

G. Transition committee holds planning session with staffTransition Committee Chair and Committee

H. Semifinalists visit office and meet with staff

Board Chair, Executive Director Candidates, and staff

I. Executive Committee holds round two interviewsExecutive Committee of the Board

J. Board meets to ratify selection Board of Directors

K. New CEO gives notice to current employer New CEO

23

Process Step



Start Date




Phase 3:

Post -Executive Search Activities

A. Transition committee plans on-boarding process:a. Orientationb. Building key relationshipsc. Determine Executive’s needsd. Focus on retaining new Executive Director


B. Organization announces new CEO Board Chair

C. New CEO starts work New CEO

D. New CEO and board embark on orientation/post-hire process

Board Chair and New CEO

E. CEO completes 90-day plan New CEO

F. Board chair engages with New CEO in 90-day check-in review

Board Chair and New CEO

G. Executive committee conducts six-month evaluation of new CEO


H. Executive committee conducts 1st annual performance evaluation of new CEO


24

This section will cover the essentials of how a PCA and Board convey the right message at the right time to the right people in order to reassure stakeholders about continuity and stability.

Change at the top is inevitable. As referenced above, a CEO may leave for a variety of reasons. How the Board and CEO handle this departure must be considered for the good of the organization and its future, and must pay attention to the needs of all of the PCA’s stakeholders.

The responsibility of the Board of Directors is to ensure the PCA’s sustainability, ongoing vitality, and a continuation of the priority objectives outlined in the Strategic Plan. A departure that is poorly handled can create a myriad of crises resulting in staff turnover, suffering morale, and a lack of confidence in the organization. A change at the top can create anxiety, internal tension and instability, or feelings of sadness and loss, particularly if the outgoing CEO has been in place for a very long time. A poorly handled departure of a CEO also sends a powerful message to any prospective CEO candidate about the lack of planning and disorganization that might exist within the Board and/or organization.

In short, “a good ending” to a CEO’s tenure, regardless of circumstances, will have a great deal to do with a “good beginning” for the next CEO. In fact, a change at the top can also signal an opportunity for the organization and its stakeholders to take itself to the next level and build on its current strengths and capabilities. The saying “crisis is opportunity” has merit, even if the departure is planned. While transitions are about managing risks, it is also about identifying the positives that might present themselves with the departure of one CEO and the arrival of the next given the organization’s needs in the future.

The basics of “departure management”1. Have a written Succession Plan in place that

anticipates a departure based on any eventuality.2. As part of the development or revision of a Succession

Plan, the Board needs to have a frank conversation with itself, and where appropriate their CEO about the importance of transition or departure management. This discussion must focus on the importance of organizational sustainability, and not focusing exclusively on the CEO.

3. Once the reasons for the departure are clearly understood by the Board, and once it formulates its “action plan” relative to finding a successor, it must

have a clearly articulated “communication plan” for all internal and external stakeholders. The Board must be prepared to communicate early, often, and honestly if it wants to maintain the confidence and credibility of stakeholders. Conversely, a lack of communications about a Board’s plans in the case of a CEO’s departure will exacerbate the natural anxieties that come with this kind of change.While good communication is essential, it is even more important to understand that what you are communicating about the transition will have a long term effect on the health of the organization.

4. The reasons for the CEO’s departure should be explained to whatever degree is appropriate under the circumstances. A planned retirement, for example, is easy to explain. Reasons that have to do with bad performance or legal matters are much more difficult. Regardless, the Board must address them as honestly as possible to reassure stakeholders and remind staff, health centers, and others that “we” (the Board) will guide you through this period of transition building on the organization’s strengths and successes and result in an even stronger Association.

5. Telling the “story” is only the beginning. The channels of communications must remain open. The Board needs to ensure that a two-way communications process remains in place. Such a process will be reassuring, raise the credibility of the Board, and reduce the normal anxieties that arise during periods of change.

The Basics of a Good Communications Plan• If the CEO’s departure is sudden and unexpected, the

Board should appoint a “spokesperson” to prepare the message(s) and timing of communicating to internal and external stakeholders

• A communications plan should have all key stakeholders identified in advance. Internal and external stakeholders are important to notify when a transition is taking place so that they learn of this change from the Board, and not from the “grapevine”.

• A good plan will have considered the “medium” of choice to communicate the news of a transition. It will vary depending upon your audience and might include written information as well as a personal “outreach” or meetings to convey the message in a positive and constructive way. In other words, “know your audience”.

X. Departure Management and Communications

25

• Messages about such an important transition need to be clear, succinct, informative, and reassuring. Keep in mind that this is an excellent opportunity for a Board of Directors to demonstrate its value, commitment to the organization and the people it serves, and its commitment to the concept of sustainability.

• When a CEO’s departure is sudden, it is essential that the Board’s plan of action be clearly communicated as quickly as possible. The risk of this kind of development clearly reminds us of the importance of having a Succession Plan in place under any circumstance.

The Message • The Board needs to be the entity that announces

a CEO transition, particularly if it is sudden or unanticipated. Depending upon circumstances, a departing CEO and Board may choose to make the announcement together.

• The message needs to let its audience know that the Board has planned for this kind of eventuality and will be moving forward to implement its Succession Plan in a way that insures continuity and sustainability.

• Depending upon the reasons for a CEO’s departure, the Board’s message needs to either acknowledge the outgoing CEOs accomplishments and regrets his/her “moving on” or acknowledge that unanticipated circumstances have taken place but the Board will ensure the transition to a new CEO will be smooth.

• The message should convey the actual steps the Board will take moving forward, including the appointment of an Interim CEO if appropriate.

• The Board should take the leadership role to meet directly with employees in order to demonstrate commitment to them and the organization’s continuity. It should also know which external stakeholders are essential to call personally (e.g., key political figures, HRSA), and which would be appropriate to notify in writing.

• The Transition Committee needs to keep all key stakeholders up to date on the progress of the Succession Planning process as it will reduce anxieties that naturally occur when there are too many unknowns. This communications should take place at the time of the announcement, at the beginning of a process to identify and hire a new CEO, at the time of interviews, and when a selection has been made. If the Transition Committee has involved staff and/or external stakeholders in the hiring process, it is important to clearly indicate this.

• Communications with all parties need to keep the door open for questions from stakeholders. Someone on the Transition Committee should be identified in advance as that “point person”. It is rarely appropriate for the outgoing CEO to be the communications link

to internal and external stakeholders, other than to reassure folks that a process is underway and that all will “be well”.

• It is best to notify staff and key stakeholders first before the final CEO selection is announced through a press release.

• The Board needs to be prepared to adjust its communications plan “mid-stream” as appropriate depending upon circumstance.

The case for “overlap” from one CEO to anotherThere can only be one person in charge of an organization, even if the outgoing CEO is beloved, wise, highly accomplished, and a font of information and knowledge. It is essential that staff, Board members, and external stakeholders all know who is now at the helm, and that this person was selected to be the new CEO because of their own unique qualities and capabilities. With this understanding, it is strongly recommended that to whatever degree possible and appropriate there be some degree of overlap so that a “downloading” of knowledge, history, subtleties, etc. can be passed on from one CEO to the next. It is also a wonderful opportunity for the outgoing CEO to actually make the introductions of the incoming CEO to external stakeholders with whom he/she has built relationships that will be important to sustain.

However, it is imperative that the outgoing CEO no longer occupy his /her office or even work out of the PCA space. Rather, it would be preferable for this person to be off-site and available on either a scheduled or as-needed basis to insure the overlap allows for a maximum amount of information sharing.

This overlap “model” is desirable when this departure is taking place under positive circumstances. Should the CEO’s departure be one under less than positive circumstances, then it is incumbent upon the Board to ensure that its existing Succession Plan have all of the needed information to pass on to the new CEO to minimize as many learning curves as possible.

26

The most significant cause of dissatisfaction when a new employee begins a job is discovering poor or no support to become “grounded” and as quickly up to speed as possible. This needs to be of the highest priority for both Board and staff members of the PCA during the initial months of a new CEO. Board and staff need to address the following priorities:

• Attitude – what can we do to have this person comfortable and focused on success?

• Communications – what processes should the Board put in place to ensure regular ongoing formal and informal dialogue with the new CEO as he/she gets fully oriented? Similarly, what mechanisms should be in place for the new CEO to immediately become familiar with staff and their strengths?

• Priorities: What are the most important goals that the PCA needs to achieve in this person’s first 6 and 12 months? What resources need to be in place in order to achieve these goals?

• Have a well-developed Orientation program with the Executive Board members that cover:

1. Building relationships with staff, Board members, public officials, and PCA members

2. Immersing him/herself into the organization to fully understand its programs, budget and financing issues, as well as each staff member’s strengths and opportunities for growth

3. Understanding the “branding” identity of the PCA; how is it seen and valued by members and external stakeholders?

4. The Strategic Plan5. Membership issues; goals & objectives to

support members6. Key external stakeholders (e.g. elected

official, public policy “players”), HRSA, NACHC…with plans to meet all stakeholders over time

XI. Onboarding the New CEO

27

“Before everything else, getting ready is the secret to success” – Henry Ford

“If we would first know where we are and where we are tending, we can than better judge what to do and how to do it” – Abraham Lincoln Ford and Lincoln are just two of many great leaders who understood the need to look ahead and prepare for the future. Health Centers have the wonderful opportunity to have an enormous impact on the well–being of millions of people. Through the efforts and assistance of Primary Care Associations, Health Centers have a greater ability to meet those needs. Each PCA must therefore embrace their responsibility to ensure that the departure of its leadership does not reduce its ability to be a resource to the health centers. The “instrument” that best enables an organization to remain vital and relevant when its CEO departs is a practical Succession Plan.

XII. Conclusion

28

1. Experience in a non-profit trade association setting; possessing great skill sets at influencing others with diverse interests and priorities

2. Your new CEO should have a strong “partnering” philosophy; be collaborative in nature; have a record of working effectively with a wide variety of constituents and decision-makers. Be effective as a “consensus builder”.

3. The new CEO needs to have had solid experience in the public policy & advocacy area, particularly with governmental entities.

4. Given the critical need to have a positive working relationship with your Board, it would be important that your new CEO has demonstrated such a relationship previously; it is essential that he/she understand the fiduciary responsibility of a Board of Directors and its role with respect to this responsibility.

5. Your new CEO should be someone who understands the dynamic health care world enough to bring a “vision” to the table that maintains the important role the PCA plays in the evolving healthcare delivery system at both the state and national level.

6. The CEO needs to possess strong interpersonal and communications skills given that this person is the face of the organization and represents its membership externally while managing it from within. Must be effective at building credible and trusting relationships.

7. We would be looking for a CEO who has a successful track record of “financial stewardship”; someone who has strong competencies in the financial management part of running a non-profit organization or a business.

8. The CEO must be able to demonstrate that he/she has been effective as a “change agent” while leading an organization in order to remain relevant and influential in an ever changing external environment.

9. The new CEO must be a “strategic thinker”; helping members be successful in today’s environment while anticipating and planning for changes in the future.

10. The new CEO needs to have a track record of working well with his/her Management team; must have a “team philosophy” and participatory management style.

11. Your preference would be that your new CEO has health care senior leadership experience in a not-for-profit “mission driven” setting. Experience with health care associations or association management a major plus.

12. Given the nature of such a role, the new CEO must be able to function effectively during challenging and stressful times. Must be comfortable managing conflicting agendas and helping others get to a “win-win” outcome.

13. Familiarity with key issues such as health reform,

integration, and Medicaid will be of strategic importance as the CEO assists its member in their positioning for the future.

14. Familiarity with State X a major plus in terms of minimizing a learning curve, developing relationships with key elected officials and funding agencies, and in understanding the existing provider community.

15. The CEO must possess a high degree of Emotional Intelligence which is highly correlated with leadership success, particularly in complex organizations

16. The CEO must be committed to the growth and development of all staff and the Board of Directors

17. The CEO must have a track record of developing innovative solutions and strategies for service delivery; promulgation of leading practices.

18. Experience in working with metrics and performance contracting critical

19. The CEO must be willing to travel extensively: In State to all health centers, external stakeholders, policy makers etc., as well as nationally to represent the needs of the state’s health centers.

Note: this list is a sample. Each PCA will modify its Core Competencies based on its own needs and how they relate to the organization’s Strategic Plan.

Appendix 1: Sample Core Competencies & Experiences of PCA CEO

29

Advantages of Using a Search Firm1. Ensures that a panel of strong competitive candidates

are “brought to the table” to compete with one another and with any internal candidates. Should an internal candidate be selected as a result of such a competitive process, it will bring extra credibility to the process and selection.

2. A professional search firm should be extremely well-networked and have immediate access to a wide variety of candidate sources and individuals with whom they have previously built relationships. Search firms rely on contacts and relationships to find “impact players”, and not job boards. It has been our experience that the best candidates for a “C-Level” position are individuals who are not looking to leave there current job and who are not checking job boards to see what is out there. It is typically an enthusiastic call from a professional recruiter that engages a prospective candidate to give an opportunity some real thought.

3. Professional search is all that a search firm does. A good search firm should understand its client’s industry intimately, understand the role for which he/she is recruiting, and have the resources needed to engage in these activities on a 24/7 basis (typically it is night-time calls that are required in order to have in-depth conversations with prospective candidates).

4. A professional search firm is able to bring “tried and true” processes to its clients. This would include testing capabilities, behavioral questions that can be used during the interview process, ratings scales, and an ability to facilitate staff and Board interviewing processes in order to maximize the opportunity for an outcome that is insightful and thorough.

5. A search firm is experienced at ensuring that a process “flows” and isn’t compromised by intermittent delays due to logistical challenges. Nothing discourages candidates more than discovering that an organization is disorganized and doesn’t have a sense of focus and urgency for such an important event as the selection of a new CEO.

6. A good recruiter will get to know his/her candidates quite well, including the development of an

understanding of any family dynamics that will play a part in the final outcome. It is having an appreciation for the nuances of an individual candidate’s interest in a job that often helps a Board make a wise decision.

7. A search firm is experienced at helping “close the deal” with the final person selected, thus taking the awkwardness out of the negotiating process. He/she should know the client’s financial parameters and the candidate’s financial needs in ways that will result in the outcome feeling like a “win-win” proposition. A good recruiter will also be quite familiar with the marketplace and the kind of arrangements being negotiated elsewhere for similar organizations.

8. A search firm, by definition, is an objective third party that will apply clear criteria to a selection process, thus keeping the influence of personal “favorites” or “political” referrals to a minimum. The Board will clearly outline what it seeks in a new CEO, and will allow the search firm to screen internal and external candidates in and out of the process based on these objective criteria.

9. A volunteer Board simply does not have the time or resources to conduct a search on its own for a new CEO. The selection of a new CEO may be the most important decision a Board of Directors will be asked to make, and so it needs to be assured that the process is conducted in a professional, thorough, and timely way.

10. A search firm that is experienced with a given industry and given role within that industry can be an effective consultant to the Board and staff through the entire process which in turns gives the entire process a sense of professionalism. This is particularly important if that firm also understands the external forces at work in the current rapidly changing healthcare world.

Advantages of not using a search firm

1. Cost: Engaging a search firm does indeed cost more for an organization to conduct a search on its own…even if it does have the resources to actually conduct a proactive search through a marketing campaign rather than simply posting the position on various sites.

Appendix 2: Using a Search Firm

30

2. Timeliness: It is likely that a search that is limited to either internal candidates or local candidates will take less time than one results in marketing efforts that reach out to hundreds of individuals throughout the region and country.

3. When the Search Consultant’s knowledge of that community and organization is “limited” there may be a risk associated with bringing in a 3rd party firm that is not familiar with the culture of a community or organization and expecting that person to be an effective face of the organization. This risk is minimized by insuring that the search firm spends adequate time getting to know the organization and community through a visit and discussions with all key stakeholders prior to the initiation of the search. This risk is further reduced by engaging a firm that is already familiar with that community and what it takes to be a CEO of a health center.

4. Unique Regional Issues and environment: There are many Boards that feel their “ideal” candidate should come from a nearby region or their own state given the nuances and subtleties that are associated with that particular community and state. We often hear “there is no other state like ours and we’d want to avoid the learning curve associated with bringing in a new CEO from another state. Limiting the pool of possible candidates in this way does have its drawbacks, but there is certainly some value in recruiting locally or regionally from a learning curve perspective. Should this be the search focus of an organization, it is certainly possible to conduct such a search without the use of a 3rd party search firm as long as some resources were in place to seek out candidates proactively and not rely simply on advertising and job boards.

31

Appendix 3: Emotional Intelligence Overview1

1 https://ei.mhs.com/Portals/0/EQ-i%202%20Sample%20Report%20-%20Client%20-%20redacted.pdf

Copyright © 2012 Multi-Health Systems Inc. All rights reserved.

SELF-PERCEPTION

Self-Regard is respecting oneself while understanding and accepting one’s strengths and weaknesses. Self-Regard is often associated with feelings of inner strength and self-confidence.Self-Actualization is the willingness to persistently try to improve oneself and engage in the pursuit of personally relevant and meaningful objectives that lead to a rich and enjoyable life. Emotional Self-Awareness includes recognizing and understanding one’s own emotions. This includes the ability to differentiate between subtleties in one’s own emotions while understanding the cause of these emotions and the impact they have on one’s own thoughts and actions and those of others.

SELF-EXPRESSION

Emotional Expression is openly expressing one’s feelings verbally and non-verbally.Assertiveness involves communicating feelings, beliefs and thoughts openly, and defending personal rights and values in a socially acceptable, non-offensive, and non-destructive manner.Independence is the ability to be self directed and free from emotional dependency on others. Decision-making, planning, and daily tasks are completed autonomously.

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EMOTIONAL & SOCIAL FUNCTIONING

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EmotionalIntelligence

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SELF-PERCEPTION

MAKING

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INTERPER

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ibili

ty

MAN

AGEM

EN

T

STRE

SS

Problem

Solving

Reality Testing

Impulse ControlM

AKING

DECISION

Interpers

onal

Relationship

s

Empath

y

Social Responsibili

ty

INTERPER

SO

NAL

IndependenceAssertiveness

Emotional Expression

SELF-EXPRESSION

Self-AwarenessEmotional

Self-Actualization

Self-Regard

SELF-PERCEPTION

Copyright © 2011 Multi-Health Systems Inc. All rights reserved. Based on the original BarOn EQ-i authored by Reuven Bar-On, copyright 1997.

STRESS MANAGEMENT

Flexibility is adapting emotions, thoughts and behaviors to unfamiliar, unpredictable, and dynamic circumstances or ideas. Stress Tolerance involves coping with stressful or difficult situations and believing that one can manage or influence situations in a positive manner. Optimism is an indicator of one’s positive attitude and outlook on life. It involves remaining hopeful and resilient, despite occasional setbacks.

DECISION MAKING

Problem Solving is the ability to find solutions to problems in situations where emotions are involved. Problem solving includes the ability to understand how emotions impact decision making. Reality Testing is the capacity to remain objective by seeing things as they really are. This capacity involves recognizing when emotions or personal bias can cause one to be less objective. Impulse Control is the ability to resist or delay an impulse, drive or temptation to act and involves avoiding rash behaviors and decision making.

INTERPERSONAL

Interpersonal Relationships refers to the skill of developing and maintaining mutually satisfying relationships that are characterized by trust and compassion.Empathy is recognizing, understanding, and appreciating how other people feel. Empathy involves being able to articulate your understanding of another’s perspective and behaving in a way that respects others’ feelings.Social Responsibility is willingly contributing to society, to one’s social groups, and generally to the welfare of others. Social Responsibility involves acting responsibly, having social consciousness, and showing concern for the greater community.

EQ-i 2.0 Model of Emotional Intelligence

Name: Ms. Sample

4 1122041820112.0

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Sample Questions for PCA CEO Interviews:Note: Naturally, each PCA has a different set of priorities and challenges, and so interview questions will be developed with that PCA’s unique circumstances in mind.

1. Tell us a little about yourself, and why this position at this point in your career is of interest to you. What makes it particularly exciting, and what would you see as a particular challenge you would face in taking on the CEO position?

2. This moment in the history of health centers has been described as one filled with both great opportunity as well as great challenges. As a CEO of a Primary Care Association, what talents would you “bring to the table” that would allow your membership to “seize the moment”, and how would you overcome the challenges facing this industry?

3. As you know, running any organization involves working with multiple constituents and Boards with a diversity of opinions and perspectives. Can you give us a sense of how you would work effectively in such a setting, and examples of a time you demonstrated your ability to do so and a time when your efforts were less than successful”?

4. From what you have learned about our Association, how would you structure your activities for the first 30-60-90 days?

5. Please share some observations you have made after reviewing our Strategic Plan? And if you were CEO, how would you monitor and report on progress being made?

6. You’ve also had a chance to look at some summary information on our Year-to-date financials. What questions surfaced for you, and what would you like to know most from the Board about these financials?

7. What would you do to reach out to the non-member health centers in our state to get them to become members?

8. Please reflect on why you feel you would be an asset in the CEO role of our PCA?

9. Looking at your last job, what’s different about the organization as a direct result of your work there?

10. Please give us an example of a really significant obstacle or challenge you have faced in your career and how you tackled it.

11. What skills and specific experiences would you draw on to raise the visibility of our organization?

12. As CEO of our Association, what are the key things that you will expect from the Board and what should they expect from you?

13. Given what you know about or organization, why do you think you are well suited to become CEO? And what do you think would be most challenging if you were in the role?

14. How would staff who have worked for you before describe you as a leader? And why would they describe you that way? How about as a manager? Why…and can you give an example of why they would draw that conclusion?

15. Tell us about your communications style in general…and ways in which you motivate your staff, deal with difficult employee situations, and go about resolving conflict. Feel free to give examples. How would your style differ as the CEO of a Primary Care Association relative to working with multiple constituencies who do not report to you?

16. How do you introduce change in an organization? Please share 2 examples, one successful and one not-so successful, where you were involved in implementing a major change. Please speak to the short term and long term approaches used and what you learned from each effort.

17. Tell us about your decision making style, and what we could expect should you become the CEO. Could you give us an example of how you have applied this style in the past?

18. Talk to us about how you foster collaboration within an organization, and please give us an example of how you have done this in the past.

19. What accomplishment do you take most pride in as you think about your most recent position? What was your biggest disappointment, and would you have approached this issue in a different way if you had the opportunity?

Appendix 4: Sample Interview Questions

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20. Could you give us an example of how you have had a positive impact on business processes or systems in an organization?

21. Can you describe your experience in the areas of training and technical assistance, giving us an example of a time your efforts were particularly helpful and a time when your efforts did not accomplish your objectives?

22. What would you like us to know about you that hasn’t yet surfaced during this discussion?

23. What questions would you like to ask us?

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Appendix 5: Candidate Rating Scale

PCA Ratings Scale

Qualities Identified as Critical for CEO (sample)

5 = Outstanding 4 = Strong 3 = ok 2 = weak 1 = poor N/A = unable to judge

Criteria Candidate 1 Candidate 2 Candidate 3

The leader factor(“shepherding” a group of diverse leaders toward a common goal)

The passion factor for our mission

The “visionary’ factor

Financial Leadership

Association experience

External visibility/communications; ability to build PCA’s stature and raise its profile

Board relations/development

Public Presentation; being the “face” of our PCA

Relationship Builder/Partner

Integrity/Values

Innovative, Entrepreneurial“risk taker”

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Criteria #1 #2 #3

Change Agent

Regulatory/Compliance Experience

Commitment to Integration (Behavioral Health & Primary Care)

Agility, Flexibility

“Chemistry” or “Fit”

Consensus Builder

“Inspirational”; great motivator

Management Skills; ability to effectively run an operation

Staff Leadership & development skills:

Other trait:

Candidate Strengths

Areas to further explore

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Documents

SUCCESSION PLANNING FOR PRIMARY CARE ASSOCIATIONS