City Case Study
Reintroductions in Transition in Cleveland, Ohio
Alignment and resilience during leadership transitions
Organizations Involved
The Cleveland coalition brought together MetroHealth, one of the region’s most prominent health systems, and Metro West Community Development Organization, a well-established neighborhood-based partner. MetroHealth participated through staff with expertise in community development and real estate, extending its role beyond direct healthcare delivery to issues tied to housing and environment. Metro West entered the program under new leadership, with a director who brought a background in public health and policy but limited direct history with the Clark-Fulton Master Plan. Both organizations saw the Alliance process as an opportunity to reintroduce themselves to one another, build new working relationships, and renew accountability for a plan that had lost cohesion over time.
Community Context
The Clark-Fulton neighborhood is centrally located and has long been positioned as a focal point for redevelopment efforts linked to health anchors, housing stability, and small business growth. The neighborhood contains strong assets, including cultural institutions and a dense network of community organizations, but it also bears the burden of lack of sufficient investment and incomplete follow-through on prior planning efforts.
The Clark-Fulton Master Plan, launched in 2021, was envisioned as a comprehensive revitalization roadmap. It was designed to align five core partners—MetroHealth, Metro West, the City of Cleveland, a major philanthropic foundation, and a council representative—around a shared set of priorities. The plan was created with significant neighborhood input, but momentum faded after its release. Leadership turnover, lack of consistent convening, and the absence of structured feedback mechanisms led partners to pursue individual portions of the plan rather than acting as a collective. Community members expressed skepticism about whether the ambitious vision would be implemented or left to gather dust like earlier efforts.
Type of Project
The coalition did not attempt to launch a new program or flagship initiative. Instead, its work was focused on renewing collaboration around the Clark-Fulton Master Plan, repairing organizational alignment, and building a functional partnership capable of carrying the plan forward. Success was defined not by immediate physical projects but by whether the two organizations could clarify roles, establish predictable working rhythms, and sustain a relationship that could withstand leadership changes and systemic disruptions.
Alliance Interventions
The Alliance created structured space for the two organizations to reconnect, revisit priorities, and test assumptions in a setting where candid dialogue was encouraged. Facilitation emphasized reflection, predictability, and role clarification. These sessions reinforced that both organizations were already aligned in values, but they needed process discipline to stay aligned through transition.
The structured meetings allowed Metro West’s leadership to emerge naturally, as the organization stepped back into a visible role within the Master Plan framework. MetroHealth used the process to strengthen its position at the intersection of healthcare and community development, emphasizing that housing and the built environment are fundamental to health outcomes. The facilitated dialogue also offered a way to confront tensions within the larger collaborative, where the absence of consistent engagement by other Master Plan partners had reduced collective accountability.
Challenges Faced
The Cleveland coalition encountered multiple, overlapping challenges as it worked to reestablish a stable partnership.
The first challenge was leadership transition. Both organizations had recently undergone significant leadership changes, which slowed progress as new leaders needed time to establish credibility with stakeholders, understand the history of the Master Plan, and set their own direction. This period of reintroduction was time-consuming, but it also created an opening for frank discussion about what had gone wrong in earlier phases of the plan and what could be done differently moving forward.
A second challenge came from the complexity of Cleveland’s political environment. Healthcare, development, and neighborhood revitalization are heavily influenced by local politics, which can be difficult for newer leaders to navigate. The coalition addressed this by committing to direct, transparent conversations about external pressures and the need for mutual respect in decision-making.
A third challenge was the difficulty of moving from vision to application. While the Clark-Fulton Master Plan provided an ambitious framework, translating that framework into specific projects proved more difficult in practice. The challenge was compounded by a high-profile misstep when a prior commitment tied to the Master Plan created expectations that the new leadership could not fulfill in the same form. This episode tested the partnership’s ability to hold trust. It underscored the need to slow down decisions, ensure alignment before public commitments, and pace implementation to match actual capacity.
Finally, the coalition confronted the reality that while MetroHealth and Metro West were growing closer, the broader group of original Master Plan partners was not consistently engaged. Without regular convening, the larger collaborative lost momentum, leaving the two core organizations to shoulder much of the responsibility for sustaining focus and accountability.
These challenges did not end the partnership. Instead, they became reminders that durable collaboration depends as much on process and predictability as it does on shared vision.
Successes & Outcomes
Even in the face of these difficulties, the partnership between MetroHealth and Metro West deepened. The two organizations reaffirmed their commitment to the Master Plan, adjusted timelines to reflect realistic capacity, and concentrated on areas within their direct control. By the midpoint of the program, they had created a predictable rhythm of engagement, clarified complementary roles, and demonstrated discipline in maintaining trust through uncertainty.
The partnership highlighted an effective division of labor. MetroHealth emphasized that health outcomes are shaped by housing, infrastructure, and the built environment, and positioned itself as a health anchor willing to engage in these domains. Metro West reinforced its role as a trusted community-based organization, serving as the communication channel for residents in the neighborhoods surrounding the hospital. This complementarity gave the coalition resilience even as broader partner involvement ebbed.
The reestablishment of Metro West’s leadership role in the Master Plan partnership was also significant. Community members and businesses had long looked to Metro West as a central point of contact. Its reemergence as a visible leader reassured stakeholders and helped rebuild credibility for the broader plan. MetroHealth’s willingness to support this leadership rather than overshadow it was a critical marker of maturity in the partnership.
For funders, the lesson is that facilitation and structured engagement processes are essential supports. Investing in meeting rhythms, facilitation, and tools for accountability can be as valuable as funding projects themselves.
Lessons Learned
The Cleveland case demonstrates that reintroduction and realignment are necessary during leadership changes. Successful partnerships are not only about achieving milestones but about the ability to adapt together when external systems weaken.
For practitioners, the lesson is that alignment must be reinforced through regular communication, transparency, and predictability. Leadership turnover should be treated as an opportunity to reset expectations and clarify roles, not as a setback.
Do's and Don’ts
Key takeaways from the Cleveland’s coalition's experience, what helped build momentum and what to watch out for when replicating this approach in your own community.
✓ Do
Do establish a consistent schedule of meetings with documented outcomes, so partners do not repeatedly reintroduce themselves or revisit the same ground.
Do clarify roles and responsibilities early and revisit them often, particularly during leadership changes.
Do create space for candid conversations about political realities, capacity limits, and external pressures.
Do slow the pace of public commitments until internal alignment is secure, recognizing that predictability builds trust.
Do reinforce the leadership role of community-based organizations while anchors provide reinforcement and resources.
✗ Don't
Don’t assume that commitments made under prior leadership can be fulfilled in the same way without reassessment.
Don’t rely on written plans alone; without active coordination and accountability, implementation will drift.
Don’t rush into major projects or announcements to demonstrate progress if internal alignment is still forming.
Don’t treat facilitation as optional; structured dialogue is critical when rebuilding trust and momentum.
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