Frequently Asked Questions

Below are answers to common questions about implementing complex system-level change in Title V CYSHCN programs.

What should the implementation team look like? 

Each state’s/jurisdiction’s implementation team will look different based on its organizational structure, priorities, and available capacity. Some states/jurisdictions may not have a formal group labeled as an “implementation team” for their system-change initiatives— and that is okay. The crucial factor is having clearly identified individuals who are responsible for specific tasks and decision-making. An implementation team is not an advisory group; all members should be able to make substantive contributions to the implementation of the initiative. A strong implementation team ensures there is shared understanding of roles, designated points of contact, and a structure in place to address questions, challenges, and next steps as they arise. 

While team composition will vary, it can be helpful to include individuals with expertise in the following areas: 

• Program leadership to guide decision-making
• Data and evaluation to track progress and outcomes
• Family or caregivers of CYSHCN populations to share perspectives
• Youth or young adults who identify (or identified) as part of the CYSHCN population to share perspectives
• Clinical or health care professionals to offer subject matter expertise
• Community or partner organization liaisons to support collaboration
• Policy or system-level staff to align with broader state strategies 

Bringing together a variety of perspectives can improve planning, increase buy-in, and support more sustainable outcomes.  

What is an implementation plan? What should it look like? 

An implementation plan is a guide that provides a team with an overview of the key outcomes, activities, and individuals/teams/agencies involved in the implementation of an innovation. It is a guide that helps implementation team members track and monitor progress towards implementation.  

Implementation plans should include information such as:  

• Clear outcomes you would like to achieve, and how you will measure success
• Data systems (what data, how data will be collected, used, and shared) 
• Decision-making strategies for making adaptations if you are not receiving desired outcomes
• Team member roles and responsibilities
• Timeline 
• Plan for ongoing community engagement with CYSHCN, families/caregivers, communities, and partners 

The National Implementation Research Network has developed an implementation plan template. 

What if our desired outcome might not be seen for several years after we begin implementing? 

It is completely normal and recommended to have long-term outcomes of your program’s system-level changes; these do not happen overnight! However, you should also have smaller, measurable short-term outcomes identified to ensure you are on track to meet that long-term goal. If you are struggling to think of shorter-term outcomes, it might be time for your team to go back to other stages and ensure that your desired outcomes for your implementation are feasible. 

How do we identify which partners to engage? 

There are a variety of partners that may be essential to the system-change effort, including family leaders, youth and young adults, community partners, health systems, insurers, academic partners, and even other state-level agencies. Depending on the state/jurisdiction, the specific challenge, and structure of the CYSHCN system, it is likely that all these partners will be involved in the system-change effort at some point during the phases of implementation. Some individuals will be best-suited to advise your system-change efforts; others will be helpful to have on your implementation team.  

It is not only important to consider who should be engaged, but also: 

• Why is their involvement essential?
• When is the right time to bring them in? 

These questions are not one-time decisions—they evolve. The people you engage with and the reasons for their involvement may shift as your project progresses. Staying flexible and responsive ensures your work remains relevant and impactful.