There are certainly other roles that emerge over time and need to be played, but this is a start. And if we see that a host of organizations working in concert all can contribute to the overall backbone function any community needs to have played, it can and should reduce some of the power struggles that have emerged around this important piece of the work.<\/p>\n

We have learned one additional lesson that deserves to be mentioned.\u00a0 It is helpful, especially early in this work, to have all the key staff located in the same place even if they come from different organizations. The importance of these staff sharing what they are learning on a daily basis, helps them practice the type of continuous improvement they are looking to promote across community partners. The simple reality is there will be a need for a fiscal agent and they have to sit somewhere. We recommend communities not create a new 501(c)(3) to house the staff since this work is primarily about leverage existing resources. We term wherever they land as the “anchor entity,” but whatever it is called, it need not cause conflict since it should become clear very quickly that there is joint ownership for the backbone function as a whole.<\/p>\n