8

Fiscal Stewardship 

"...the assumption of responsibility of the financial well being of another or a group. The expectation being that this responsibility will be carried out with great care, keeping in mind the good of the individual or group being served. Financial stewards have been entrusted with the financial resources of another. There is an expectation of care to be followed when acting as a steward. A financial steward would be expected to make those decisions which would best benefit the individual or group whose financial assets are being cared for; managing expense, responsible investing, and accountability."

The quote above comes from Wiki Answers....which I am sure I shouldn't cite in a doctoral paper....I am smarter than that :) However the speaker did admit to using Wiki Answers. 

Weber's Ten "Rules of Thumb" for Fiscal Stewards

Rule 1: Some fiscal decisions are black, some white, and many are grey.

Rule 2: Earning trust as a fiscal steward

Rule 3: Transparancy in fiscal matters goes a long way toward building trust.

Rule 4: Communicate - don't expect people to read your mind when you make a fiscal decision

Rule 5: Build a financial system that has backup - never allow only one person to handle funds.

Rule 6: Surround yourself with smart, knowledgable, expert help.

Rule 7: Find and use an experienced fiscal mentor.

Rule 8: Make clear your fiscal decision making - Type 1, Type 2, or Type 3

Rule 9: Understand the laws and regulations governing your profession.

Rule 10: Act as if each fiscal decision you make will find its way to the front page of 
your local paper. 

Nugget: Servant leaders must be financially responsible to serve the greater good. 

Reflection: Wow...I do not have much experience with fiscal stewardship, so this is new to me. But I don't think it is a difficult concept: As leaders we are tasked with being financial responsible for our organizational and societal well-being. When I think about financial responsibility, I think of poor examples such as Enron who's inefficient moral consciousness of a few, created a whirlwind calamity for many. 

As a leader we need to constantly keep ourselves in check through accountability. This means surrounding ourselves with people who may not agree with all of our ideas. By doing so are not delimited to groupthink, and those who may tip the scale on similar thought patterns. I need to surround myself with those who will challenge my thoughts, actions, and behaviors. Growing a team of bystanders, who rarely challenge the process, leaves a leader susceptible to human nature: greed. 

For example, my wife keeps me in check with what I want to purchase. We both call each other before we spend money. We practice fiscal stewardship by clarifying if our potential purchase is: 1) in the budget, and 2) a need or a want. If we didn't have this system, we would be terrible stewards of our money and we too would fall into the trap of greed, materialism, and over-justified purchases. Practicing poor fiscal stewardship over a period of time deters one's moral compass completely. Thus, one falls into a perpetual cycle of the dark side of human nature where money becomes used and abused. 

7

Three Types of Problems

Simple Problems - clearly defined - consensus of practice and clearly defined routines are executed to solve the problem (management)

Getting the daily job done

At Character Quest simple problems occur when we are trying to figure out how to perform logistics; getting the students from point A to point B in an efficient amount of time. 

Complex Problems - problem clearly defined - conflict related to which approach is the best way to solve the problem

Retaining talented employees

At Character Quest a complex problem occurs when we have a schedule conflict and our trainer team has to work together to figure out how to fit in our training with our outdoor experiences (missions). Each trainer has a different idea of what is the best way to fit in all the training components. It takes a flex in their teaching and training abilities to settle on a solution. 

Wicked Problems -  no consensus as the problem, nor the root cause of the problem -  conflict related as to which way to define the problem, which way to solve the problem. (politics)

At Character Quest a wicked problem may occur when we are figuring out the learning outcomes of the certification program. One individual may want the outcomes to be that of leadership competencies learned while another may want the outcomes to be that of personal meaning making. The outcomes are open to personal preference and opinion. 

Types of Problems (Beinecke, 2009). 

Wicked Problems

1.There is no definitive formulation of a wicked problem.

2.Wicked problems have no stopping rule.

3.Solutions to wicked problems are not true or false, but good or bad.

4.There is no immediate, and no ultimate, test of a solution to a wicked problem.

5.Every solution to a wicked problem is a “one shot operation” because there is no 

opportunity to learn by trial and error, every effort attempt counts significantly.

6.Wicked problems do not have an enumerable (or exhaustively describable) set of 

potential solutions, nor is there a well described set of permissible operations, 

that may be incorporated into the plan.

7.Every wicked problem is essentially unique.

8.Every wicked problem can be considered to be a symptom of another problem.

9.The existence of a discrepancy representing a wicked problem can be explained in 

numerous ways. The choice of explanation determines the nature of the problem’s 

resolution.

10.The planner has no right to be wrong; planners are liable for the consequences in 

the social sciences.

My group chose #8 to look at in relation to mental illness. 

[Every wicked problem can be considered to be a symptom of another problem]

Reflection: 

Mental illness is a 'wicked' problem because the illness can lead to various other 

problems such as: loss of job, poor relationships, divorce, crime, suicide. The wicked

problem is sparked because an individual may find themself in a negative perpetual cycle: 

losing their job, losing a friendship, divorce, and depression. The individual may begin 

to focus on the symptoms but fail to recognize the cause. The cause could be a mental 

illness such as obsessive compulsive disorder. However, the individual continually fails 

to see the source of their issue through reflection and seeking a psychiatrist. As Silver (2012) refers to the signal and the noise, the individual here is focusing on the noise (the lost job) rather than the signal (the mental illness).  

As Felix (2013) pointed out in the discussion, the individual needs to presence in order to find that signal in the noise. Looking at the entire system of symptoms and causes through a systems lens is imperative for holistic understanding. The point most people forget about presencing is you need to stop, look, smell, listen, and learn what is happening. We forget to slow down, we forget to turn down the noise in our life and pay attention to the signal. If we fail at presencing for the signal, the noise will become unbearably loud. 

Approaches to Addressing Wicket Problems

Authoritative Strategies: Turn it over to the experts

Tame the problem by putting the problem solving task in the hands of a few 

stakeholders. This may be efficient, but is subject to group-think, blind-spots, and 

narrow definition of problems.

Competitive Strategies: The best idea will win

When competition frames the process, the best idea or most efficient solution will win. However, 

these scenarios are likely to result in win-lose propositions that may not benefit the greatest 

number of the greatest good, but merely benefit those with the most power and influence.

Collaborative Strategies: Get the issue in the room

Based on the premise that by working together, both groups will benefit, these processes 

consider ways to “enlarge the pie” rather than merely divide the pie differently. However, 

collaboration takes time and the utilization of a specific skill set to function as an effective, 

truly collaborative group.

Beinecke, R. H. (2009). Introduction: Leadership for wicked problems. The Innovation Journal: The Public Sector Innovation Journal, 14(1).

Silver, N. (2012).  The signal and the noise. New York: Penguin Press. 

5

"Do what you say you are going to do" - Dr. Jaime Loftus

Congruency Builds: Trust, Engagement, Integrity

"Work is much more important than a place to go in between the weekends"

5 Goals at Stritch
1. Quality and Excellence
2. Growth
3. Vibrancy
4. Reduce Complexity
5. Branding and Telling Story

Thomas Cronin
Peter Drucker

Nugget of Knowledge: Service is equipping individuals to become a better version of themself. 


Reflection: 

Service falls on a complex continuum. On one side of the spectrum, the servant can serve the individual to the point that that they become ill-equipped. Like a mother who does their child's laundry until the child is 25. On the opposite side of the spectrum, a servant can serve the individual so that they become equipped. In this case the mother takes the time to patiently teach their child how to do their own laundry.

The servant is constantly balancing enabling and equipping the individual they are serving. It would be wrong for the founders of RR to enable the behavior of the individuals and suggest for them to play the welfare system, not work, or make excuses for their circumstance. However, these founders are equipping these individuals and truly following Greenleaf's (1977) test of making the individuals grow and gain more autonomy. Seeing two people make such a difference within the community was inspiring for me as a servant and leader. I am a huge advocate of organizations that help equip individuals with life skills, leadership skills, and strengths. This organization captures the essence of servant leadership, by equipping at-risk individuals with the ability to climb out of their current circumstance. 



Greenleaf, R. K. (1977). Servant leadership. New Jersey: Paulist Press

Day 4: Gandhi Day

Gandhi

1869 - 1948

Today Prasad Gollanapalli, managing trustee of the Gandhi King Foundation came to share with us his thoughts on leadership, learning and service. The mission of the Gandhi King Foundation is: 

"To promote and work for Sarvodaya Social Order - a society based on the principles  of Welfare of all, equality of all, respect for all, a society built on the foundations of truth and nonviolence, compassion, cooperation with the spirit of understanding, tolerance, peaceful coexistance, human values, Peace with Justice in a sustainable world" (http://www.gandhikingfoundation.org/Philosophy.jsp). 

The Transformation: Arrogance to Humility

Dr. Nancy Blair referred to servant leadership as the transformation from arrogance to humility. It is an inherent trait of human nature to be arrogant. We have to work diligently and practice the idea of humility. Think about it - A baby is born arrogantly demanding to be fed, burped, changed....and the list goes on. However, a parent's job is to teach their kids the virtues of sharing, thankfulness, peace, and kindness - humility. `

By adulthood, we battle the arrogant side of our personality, and have to work very hard to transform towards humility. In this transformation to humility we must submit to the forces of a truth; a truth that one individual cannot have all the answers. A truth that one individual cannot change society on their own. A truth that one individual truly knows nothing. Thus, based upon this anecdote, humility must be learned. 

By submitting to this truth we become more dependent on others, more willing to listen, and more adept to service. We put our guard down, and become more humble. 

So, how can I as a leader move from arrogance to humility?

As I reflect on this question I think about the doctoral process in our program. The dissertation process in doctoral school requires the student to become diligent in their expertise of a particular subject - world class expertise. However, at the same time we are tasked to become more humble in our final service themed year of the program (I am currently in the final year of the program).  The juxtaposition comes from attaining world class expertise while simultaneously choosing humility as our virtue. I have to begin practicing humility in this final year of the program. 

"[One] who claims only to be a humble searcher after Truth, knows his limitations, makes mistakes, never hesitates to admit them when he makes them and frankly confesses that he, like a scientist, is making experiments about some of 'the external verities; of life, but cannot even claim to be a scientist"

6

Quick Thoughts 

Today we began our case study on the topic of mental health. The Ted talk discussed 3 irrational beliefs of mental health: remove stigma, we separate mind and body, and people think their mental illness is a death sentence. 

We defined mental illness as: a mental, behavioral, or emotional disorder resulting in function impairment (National Institute of Health).

We defined mental health as: a state of physical, social, and mental well-being

Dr. Tony Frontier (2013) reminded us that "everything is the way it is because it got that way." This statement reminds me to understand that every people, place, thing, or idea, has a history - a past. The manifestation of this past makes up the present. This reminds me of the learning year, where we dove into the concept of nurture vs. nature. The environment, influences, and encounters one experiences can nurture their development which will affect their behavior and make-up. 

Reflection: The topic of mental health is fairly new to me, so this process of exploring illness of the mind is unmarked territory for my personal education. While I have never experienced mental illness in my immediate circle, I am aware of the three irrational beliefs of mental health the Ted talk (Denny Morrison) discussed. One particular point the Morrison made was the idea looking at those with mental health issues through the lens of individual liberty vs. public safety. I have have a difficult time witnessing those who are clearly mentally ill walking the streets like a ticking time bomb. But at what point do I as a citizen intervene? Is it my individual liberty to intervene for the sake of public safety?

These questions prompt me to return to the liberty vs. safety argument. Through a service lens, I belief we as citizens are responsible to look out for the greater good of public safety. For example, if I am walking down the street and see an individual that is clearly mentally ill walking toward a park where children are playing,  I would report the incident to the police for the greater good of the children's safety. Bob Rabe (2013), in my mental health group, suggested that this method of reporting the individual to the police could be a "window of opportunity" for the sick individual to possibly receive help. This perspective looks at the greater good of the individual and the children, in this particular scenario. 

A few months back while staying at a hotel in Kenosha, I experienced the fear that an individual with mental illness can inflict on society. It was midnight, and I was sitting in the lobby reading a book when a man turned the corner. He smelled terrible, wreaked of alcohol, and decided to sit right next to me. He kept asking me my name, "Hey you, whats your name man?" It became increasingly annoying, to the point that I got up and began walking back to my room. When I turned the corner to go to my room, I thought of all the children that could be walking through the halls by themselves. I thought about the little old lady that may be on holiday at hotel. It was at that moment I became cognizant of the public safety of the residents of the hotel. I went straight to the front desk and reported the individual to the staff. Within minutes the police were there assessing the situation. 

In this situation I believe I looked out for the greater good of the public. Additionally, I looked out for the greater good of the alcoholic individual. In reporting this man to the police, I really hoped that he would be arrested, which could possibly lead to his personal reassessment of his alcohol problem (of course when he sobered up). Additionally, I hoped this intervention could lead to the individual to consider therapy or treatment. 

Group Thoughts

Acting like judges before acting like scientists

The people that are making the informed decisions have no connection to mental health (this is a generalization). 

What is it was turned into brain-illness (reframing concept of mental illness)

There is an unavoidable tension between the urgent need for transformation and the longer-term nature of scientific progress. Thomas R. Insel, M.D. Director, NIMH

Communities dont have the equal access for youth who suffer from mental illness

How to minimize the financial

Group Notes

Schizophrenia, bipolar disorder, depression, post-traumatic stress disorder, eating disorders, autism, and other disorders are serious, often life-threatening, illnesses for which we need reliable diagnostic tests, new treatments, and effective strategies for prevention.

Mental Health America

MHA

Although the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) was enacted over four years ago, a final rule implementing the law has not yet been issued. Without a final rule from the Administration, many individuals seeking care for mental health and addictive disorders have been unable to access the health care services they need.

The Administration has promised a final MHPAEA rule by the end of the year, but they have not clarified if the needed protections will be in the final rule.  The Administration needs to hear from patients and providers who have experienced parity violations so that these practices are clearly prohibited in the final rule. Parity violations include plans denying or more strictly managing mental health and addiction treatment services than other services covered by the plan.  More information may be found at www.parityispersonal.org.

Send an email describing your parity violation story to both the Departments of Labor and Health and Human Services.  We encourage stories to be reported by either patients or providers who are dealing with the parity issue. A sample template is below.  Be sure to tell your personal story and attach any relevant documents (if available) such as a denial letter, summary of benefits or other materials provided by the health plan.

To assist you with understanding the common problems with parity that other providers or consumers have registered, see the below examples:

1. Outpatient sessions are being limited by utilization review (also known as medical necessity review) and this is not being done for medical and surgical conditions.

2. Provider reimbursement rates are too low, so the provider has to offer services out-of-network and the patient has to pay a higher out of pocket for their treatment.

3. The insurance company has labeled my treatments as “experimental” and therefore are refusing to pay for those treatments, leaving the patient to pay 100% out of pocket, or go without.

4. The insurance company says that my plan does not cover residential treatment or intensive outpatient care.

5. The insurance company says that my plan does not cover inpatient or residential treatment unless it is provided in an acute care hospital, but most of the treatment providers are non-hospital based facilities.

6. The insurance company says that they do not authorize any inpatient treatment at all for my opioid addiction, and that I must detox on an outpatient basis.  

7. I have requested from my insurance company the reason why they have denied my care and they will either not respond to my requests for further information, or they refuse to tell me what they do for medical and surgical care, or they refer me to an enormous website that I cannot discern any information from.

http://www.parityispersonal.org/

The Parity Implementation Coalition was formed to help ensure that the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA)-- a federal law that protects a group health plan's mental health and/or substance use coverage benefits -- is properly enforced. If you are a patient or provider who has complaints, we would like to hear from you. Depending on the nature of your complaint, we may be able to provide help in resolving your problem or point you to other resources. Your reports will also help us identify potential patterns of critical concern to federal regulators.

We provide online resources with information about:

·         What the federal law covers

·         How a state's law works with the Federal Parity Act

·         How to file an insurance claim with your health plan when benefits have been denied

·         When an external review is necessary

·         What it means to file an ERISA claim

Questions We Have...

How do we help?  When we see someone on the street exhibiting mental health concerns, at what point would you intervene? When does it look like helping someone in cardiac arrest?  If someone doesn’t want to be helped, who are we to determine that they, in fact, do need it?  How can we help foster identification and offer support earlier (in children)? What is the cost-benefit analysis of the current system?  What are the rights of the mentally ill?  What are the rights of family and community members (in relation to the mentally ill)?

Where We Can Advocate....

Departments of Labor and Health and Human Services

Wisconsin Office of the Commissioner of Insurance

State legislators

Increase public awareness through letters and articles in prominent newspapers and journals, media

Insurance Companies

Ourselves - through self-awareness and education

Prison system

Who Is Impacted...

If it is a systemic problem, which we believe it is, then all of society is affected. Until it impacts us in some way, we may not be moved to act, but it affects all of society.  We are only as strong as our weakest link.

This is connected to the homeless issue and the gun violence issue from last year.  This is a root cause to homelessness (and other societal issues).

What the Problem is....

There is an unavoidable tension between the urgent need for transformation and the longer-term nature of scientific progress. Thomas R. Insel, M.D. Director, NIMH

There is a continuum of need...

1. Those who have family structure of support and appropriate resources
2. Those who have family structure of support but limited resources
3. Those who have no family structure of support or resources

Access to insurance, appropriate diagnosis is inconsistent

Appropriate comprehensive medical care is not readily available

Resource allocation and prioritization of the issue

Currently - Reactionary approach; Needed - Proactive approach

Who Has the Power...

Politicians

Employers

Doctors

Those who have the resources

Law enforcement

Insurance Companies

The mentally ill themselves

Who Has Responsibility....

We all have responsibility, but are not necessarily taking that responsibility

How We Can Help...

From NIMH

• Promote Discovery in the Brain and Behavioral Sciences to Fuel Research on the Causes of Mental Disorders
• Chart Mental Illness Trajectories to Determine When, Where, and How to Intervene
• Develop New and Better Interventions that Incorporate the Diverse Needs and Circumstances of People with Mental Illnesses
• Strengthen the Public Health Impact of NIMH-Supported Research

Foster conversations among community organizations addressing mental health to maximize use of resources

Simply listen

Facts:

• Only 12% of people with diagnosable psychiatric disorders receive minimally adequate treatment
• The National Institute of Mental Health estimates there are 3.6 million American adults with severe mental illness that is untreated. Of those, 200,000 are homeless and 319,000 are in jails or prisons.
• Today, 20 times more people with mental illness are incarcerated than in a medical facility.
• Two-thirds of all patients treated at the Milwaukee County psychiatric emergency room are brought in by police. That's roughly 7,200 people a year. One in three returns within 90 days.