Cancer Coalition Basics: CCC Coalition Organization and Leadership Structure

This Cancer Coalition Basics section covers different organizational, leadership, program and coalition staffing configurations for comprehensive cancer control (CCC) organizations. CCC coalitions are organized and led in a variety of ways. CCC programs and coalitions work together, but the nature of their relationships and delegation of work vary. CCC programs may provide financial or staff support to coalitions. CCC program leadership is generally expected to coordinate with coalition leadership and may be expected to attend coalition meetings. Some coalitions build in mechanisms to guarantee CCC program involvement or check program influence –sometimes simultaneously.

CCC Organization Types

Volunteer-Run Organization 

• “Volunteer-run” CCC coalitions generally operate through volunteered time from members and staff support from the CCC program. They do not have 501c3 status.
• The majority of CCC coalitions are volunteer-run. 

501c3 Organization 

• 501c3 CCC coalitions still operate with volunteer time from members in collaboration with CCC program staff, but generally have a board of directors and paid staff.
• While some CCC coalitions believe 501c3 status provides increased sustainability and opportunities for funding, including the ability to apply for grants and accept donations, others expressed limited capacity to comply with 501c3 requirements. (Source: 2014 Ohio CCCP survey)

University Affiliated Organization

• A few coalitions operate as university affiliated programs.
• University affiliations vary, with arrangements including the university serving as a bona fide agent of the state/regional health department, a contractor of the state/regional health department, or an in-kind home institution to coalition staff.

By being housed at academic centers, CCC coalitions may have more opportunities to collaborate with researchers and encourage community-engaged projects.

Housed Within a Sponsoring Organization

• Instead of being its own 501c3 or volunteer-run, coalitions are sometimes housed within a sponsoring organization. Being under the umbrella of another organization, the coalition has access to the larger organization's resources, which enhances efficiency and reduces duplication of efforts.

CCC Leadership Structure

CCC coalition leadership varies in organization of responsibilities, size, composition and selection. 

Organization of Leadership Responsibilities 
Single leadership groups: A single leadership group consists of CCC coalition officers and sometimes a broader group of members. It may combine multiple leadership functions including operations and planning, strategic decision-making and expert advising. 

Examples include: 

• Board of Directors consists of 10-20 members that govern the coalition, including “development, implementation, administration, and evaluation of the Partnership's Connecticut Comprehensive Cancer Control Plan.” A subset of the Board make up a standing Executive Committee of up to 10 members who are able to make decisions and vote between full board meetings.
• One coalition’s leadership group consists of over 20 diverse organizations and includes the CCC coalition chairs, CCC program director and manager, work group chairs, regional coalition chairs and other organizations depending on current needs and priorities. This leadership group is responsible for recruiting members, setting working groups, prioritizing plan areas and overseeing progress towards goals. 

Multiple leadership groups: CCC coalitions sometimes have distinct specialized groups to carry out different leadership functions, such as operations, strategic decision-making, expert advisingt, and governance.

Examples include: 

• Executive Board that consists of 5 officer positions and is responsible for implementing member decisions, making final decisions when members are unable to reach consensus and appointing Steering Committee members. Actions of the Steering Committee include tasks such as managing, directing and coordinating implementation activities of the coalition by establishing priorities, recommending processes and making decisions.
• Executive Committee (consisting of the Co-Chairs, and CCC program and coalition coordinators) to set agendas and guide the coalition. A broader Steering Committee serves as a “cross-section” of stakeholders to “hold the vision” of the coalition, determine priorities, review workplans, etc. Advisors are liaisons between the coalition and their professional, community, academic and political organizations.

Leadership & Officer Positions 
CCC coalitions have many similarities in types of officer positions, but the specific number, rights, responsibilities and expectations of CCC coalition officers are varied.

Chair: Often presides over leadership meetings, officially represents the coalition, contributes to voting or decision-making, appoints other positions, promotes collaboration and shared responsibility among members, establishes workgroups and committees, and participates in other workgroups within the coalition.

Co-Chair or Vice Chair: Works with or assists the Chair, and is expected to take over Chair responsibilities if the Chair is absent or leaves the position.

Secretary: Keeps records of meeting attendance and minutes/notes and notifies members of upcoming meetings. 

Treasurer: Has oversight over the coalition’s financial transactions and record-keeping. 

Immediate-past Chair: The previous coalition Chair and remains as an officer in order to provide continuity and experienced input. He or she may be asked to serve as chair if both current Chairs are absent, or to cast a tie-breaking vote. 

Size: Size of leadership groups vary given the differences in how they are structured. On average, they are between 5-25 people, with some that are significantly larger. Smaller executive or planning committees may consist of a handful (e.g. 4-10 people) of officers nested in a much larger group with broad expertise (e.g. 15+).

Term Length: Officers are commonly expected to serve a term of 2-3 years. Some coalitions do not have term limits.Term limits can encourage more stakeholder involvement but no term limits can allow a passionate leader to serve for many years. 

Communication: CCC coalition leadership groups commonly have quarterly meetings (whether via conference call or face-to-face) with more frequent meetings if needed. There are variations in this frequency based on leadership structure and responsibilities.

CCC Program and Coalition Staffing 

The CCCNP recommends use of dedicated staff to offset the burden of coalition work from members who have full-time jobs elsewhere. The dedicated staff:

• Supports coalition work as part of their paid job responsibilities, but does not do ALL the coalition work (which is still a responsibility of coalition members).
• Often assists with the coalition’s coordination, communication and progress monitoring work. May help secure additional funding.
• May include more than 1 person, part-time efforts and employees outside of the health department. (Source: Habit 4, Nine Habits of Successful Comprehensive Cancer Control Coalitions)

Examples:

• “The Midwest Cancer Alliance (a member of the Kansas Cancer Partnership) designated one of their staff members to provide support to the KCP approximately two days a week in a shared position arrangement. The Midwest Cancer Alliance staff person works closely with the Kansas Department of Health and Environment CCC program staff and the KCP leadership.” (Source: Habit 4, Nine Habits of Successful Comprehensive Cancer Control Coalitions)
• One state’s CCC program contracts a non-profit organization to support one staff member to coordinate the volunteer-run coalition.

Staff positions vary by the coalition structure and region but often include a combination of: Executive Director, Program Director, Policy Coordinator, Outreach Specialist, Evaluation Coordinator, Communications Coordinator