How to Inform and Engage Stakeholders to Maximize National Background Check Program Support

Many individuals and organizations are impacted by the implementation of a National Background Check Program (NBCP) screening program. Given its complexity, it is very likely to have varied stakeholder support. Keeping stakeholders informed and engaged throughout the planning, development, and implementation cycles are factors that are critical to the success of the program. Doing that takes stakeholder management, a set of “soft skills” that are more about interpersonal relations than about budgeting or business process analysis. The term is not meant to imply deception or manipulation of stakeholders’ perceptions. Instead, stakeholder management consists of a variety of activities in communication, political negotiations, public relations, and leadership with the goal of gaining and maintaining support and minimizing opposition to your NBCP project.

This NBCP resource paper provides some practical guidance and a few tools to help you keep stakeholders well informed—and give them a channel for their input, priorities, and concerns. It also will help you identify supporters and potential adversaries as early as possible, in order to build the strongest and broadest possible alliance for ensuring the protection of vulnerable long term care (LTC) recipients.

Who are the State-level stakeholders, and how can they be identified?
What is the purpose of stakeholder outreach, and when should it occur?
How does the grantee State agency interact with State-level stakeholders?
How does the grantee State agency form and coordinate project advisory groups?
How will you know your outreach to the State-level stakeholders is working?
Additional Resources

Who are the State-level stakeholders, and how can they be identified?

NBCP stakeholders are the people who represent organizations and groups that have an interest in or are affected by the development, implementation, and operation of the statewide background check program. Stakeholder management works best when all the stakeholder groups and their representatives are identified and categorized early in the project.

One way to begin is to consider influential groups or people within the State government (internal stakeholders) and those outside it (external stakeholders).

Internal stakeholder organizations for the NBCP may include the following:

• All the State agencies that regulate the covered provider types—nursing and skilled nursing facilities (NF/SNFs); assisted living facilities (ALFs); intermediate care facilities for individuals with intellectual disabilities (ICFs/IID); home and community-based service (HCBS) providers, including home health aides (HHAs) and personal care aides (PCAs); hospices; psychiatric hospitals, etc.
• Health professional licensing boards
• The State’s Criminal Justice Information Systems (CJIS) agency, which may be the Department of Public Safety (DPS), State Police (SP), or State Bureau of Identification (SBI)
• The State’s information technology (IT) agency, if IT services are consolidated
• The State legislature, especially its LTC oversight committee
• State-chartered advisory boards that address LTC.

External stakeholders include organizations that represent LTC facilities/providers, LTC recipients, and employees, such as the following: State chapters of industry associations Employee unions State ombudsman representatives The State’s Nursing Association Nurse Aide Training and Certification program managers American Association of Retired Persons (AARP) State representatives Individual LTC facilities and providers The general public within the State

It is important to maintain a list of individual stakeholders and to have some basic information about them. To build the list, start with those who signed letters of endorsement for your State’s NBCP grant application. Then, ask them about other people who could or should be involved. Update the list with names, organizational affiliations, and contact information. Other categorizations for each stakeholder are important, as well. These include level of interest in the project, level of influence, level of support/opposition and reasons, and resources (e.g., training facilities, data, electronic fingerprinting equipment, and staff).

A “stakeholder register” can help to identify and categorize the stakeholders in your State; see [1] for a sample.

What is the purpose of stakeholder outreach, and when should it occur?

The goal of stakeholder outreach and engagement is to gain and maintain support and to minimize opposition to your NBCP project’s goals. Stakeholder outreach for a State NBCP grant project is most effective early on, perhaps even during the grant application process. Stakeholders are aware that they can influence the project most easily in the beginning. Once you have an idea of what your NBCP grant program implementation activities need to be, it is time to develop a specific stakeholder outreach plan based on the State NBCP work plan and use your stakeholder register.

Here are some items to consider when developing a stakeholder outreach plan:

• Scheduling: Stakeholders most directly involved with setting program vision are probably very busy. Get calls and meetings established as early in the process as possible.
• Negotiation: Several State agencies will be key stakeholders and their support and cooperation are essential to the success of the State NBCP implementation. Plan for early involvement and negotiation with the agency’s IT provider; they will be key partners and may have requirements, competing priorities, and capacity limits that have substantial impact on the grant budget and timeline.
• Leadership: Plan increased involvement of senior level stakeholders in the early part of the project to clear obstacles. After that, high-level updates may be sufficient for them.
• Communication: Plan to have an orientation and planning session with key stakeholders to get their input on stakeholder communication needs, format, frequency, and detail. Specifically, discuss the impacts of the proposed new background check program (cost and effort, labor force, benefits) and collect the stakeholders’ issues and concerns.
• Engagement: Plan to engage stakeholder groups at different phases/milestones of program design and implementation. Solicit input and incorporate it whenever possible. Explicitly seek and confirm support for upcoming activities.
• Continuity: Plan to continue outreach throughout the project, not just at the beginning. Outreach often pays dividends later in the implementation and even operations phases of the project when barriers and obstacles arise. An updated stakeholder register and a list of stakeholder issues can be useful when discussing strategy to overcome implementation challenges.
• Public Relations: Include broader public relations information dissemination in the outreach plan. Identify the timing and messages for such public information outlets as press releases, fact sheets for providers and local groups, and updates to the State agency web page.

How does the grantee State agency interact with State-level stakeholders?

Stakeholders like to see that they have some influence. The key is to communicate and make adjustments to address concerns where possible, while keeping the major features and objectives of the program on track. The following are general guidelines:

• Early involvement is better than waiting until all aspects of your new program are “locked in.”
• Communicate basic program information broadly to begin the public relations effort. Upon grant award, provide a press release [2] and a fact sheet [3] to your public information staff. Also send these to your licensed providers and association contacts.
• Plan for in-person sessions with the State CJIS agency and with your agency IT group within a few weeks of the grant award. Be prepared to negotiate schedules, budgets, and broad requirements.
• Schedule meetings to update key stakeholders on the project’s status, and obtain their feedback on past work. When presenting upcoming plans, solicit their input and incorporate it wherever possible.
• Treat State agencies as the essential partners they are. Share grant resources, and recognize that they are a critical part of the team. Work with them so that they define the new or revised processes related to their areas of responsibility.

How does the grantee State agency form and coordinate project advisory groups?

Often direct communication to large stakeholder populations is not practical. Advisory groups serve multiple purposes, one of which is to be the intermediary between the State agency and the constituents of the advisory group members. Here are some guidelines for using advisory groups during the design and implementation of a State’s NBCP:

• Use the stakeholder register to identify potential members of project advisory groups.
• Consider two advisory groups, one each for internal and external stakeholders.
• Solicit advisory group input, and incorporate good ideas.
• Explicitly request and confirm advisory group support for upcoming activities that will affect them.
• Identify and remove obstacles faced by advisory group members (and communicate about it).
• Prioritize the rollout of NBCP capabilities to obtain “quick wins” for advisory group members to build support.
• Advisory groups should meet periodically, ideally every three to six months. Focus advisory group meetings around the following topics:
  • Program objectives and drivers, risks, and constraints, including grant award dates and dollars (always repeat this information)
  • Benefits (to various stakeholder categories)
  • Project status updates and plans, including the following:
    • The State’s specific goals and expected activities under the program
    • The State’s timeline for implementing the program and any changes
    • Types of employees and providers who will be affected and when
    • Links to additional information
    • Contact information for the State’s NBCP manager(s)/official(s)
  • Their issues and concerns (and proposed solutions)
  • How they can help
  • What information they should expect during the grant project (milestones, advisory group recommendations, status, data)
  • Advisory group input
    • Provide answers to specific questions where possible
    • When suggestions or solutions are used, give credit
    • When significant issues or concerns cannot be accommodated, state the larger goal or alternative that prevailed
    • Always give public thanks for resources or other assistance

Change management techniques can be very useful to help communicate with advisory groups, especially when the new background check program will have a direct impact on the operations of the members’ organizations. Effective change requires that partnerships are formed: internal, external, bilateral, and multilateral. Be a willing and fair partner by building in some of these change management guidelines during advisory group meetings:

• Message consistency from the lead agency
  • Identify the change
  • Why it is needed
  • Why now
• How the new program will help each type of stakeholder (e.g., facilities/providers, applicants/employees, LTC recipients, State agencies)
  • Be open about schedule and cost issues

How will you know your outreach to the State-level stakeholders is working?

One way to measure the effectiveness of your stakeholder engagement campaign is to assess the support level of the stakeholders. The goal is to move all stakeholders toward successive positions of increased awareness, decreased resistance, and increased support. One categorization is the following progression, with the objective to have all key stakeholders above the dotted line:

It is important to assess stakeholder engagement levels periodically. This can be done in a group (such as at an advisory group meeting), or in individual discussions. Depending on the relationships, it may be useful to solicit an assessment from another stakeholder.

Additional Resources

1. Sample “Stakeholder Register”

   KEYS
   Levels of Power/Interest/Resources: H=High, L=Low.
   Level of Support: U=Unaware, R=Resistant, N=Neutral, S=Supporting, L=Leading.

   Name and contact info	Agency / Organization	Power / Interest / Resources	Support Category
   Mr. Smith m.smith@example.com 211-555-1212	Director, Department of Medicaid	(Power = H) Cabinet-level position; plays golf with Governor (Interest = L) Does not really see the impact on his Department (Resources = H) Discretionary budget, technical staff for integration	Initial=U Current=R Desired=S
   Ms. Jones m.jones@axample.state.us 899-101-6789	Ombudsman	N/A	Initial=N Current=N Desired=L

2. NBCP Press Release Template. Sample press release found on the NBCP Web site at http://bgcheckinfo.cna.org/sites/default/files/public/
   StakeholderEngagementPressRelease.docx
3. NBCP Fact Sheet Template. Sample fact sheet found on the NBCP Web site at http://bgcheckinfo.cna.org/sites/default/files/public/
   StakeholderEngagementFactSheet.docx