I heard on the news recently that there’s a silver lining to the economic troubles facing us right now: people actually live healthier during economic downturns! We eat at home more, we exercise more, we’re less apt to smoke and drink, and we don’t drive as much. I hope that’s comforting to all of you as you see your budgets shrink.
The good thing about the partnerships described in the comments to my last post is that they are broadly collaborative. That makes them more resistant to economic downturns. I count 54 members of the The Eat Smart, Move More Leadership Team – groups from academia, the medical industry, and non-profits; groups that are local, statewide, faith based, youth-oriented, and farm or school oriented; groups that focus on nutrition, or activity, or the environment that encourages healthy living. Bringing all these groups and individuals together to gather information and then actually DO something with that information is exciting. Someone will always have a new idea, the right expertise, and "know someone who knows someone" who can get it done.
“Vaccinate and Vote” is a collaboration between the Virginia Department of Health and the Augusta Medical Center and Eastern Virginia Medical School. It’s exciting because it brings together academia, the public health system, and a private health care center – around an issue important to all of them. The breadth of this type of collaboration is always a good thing in turbulent economic times, because it shares the cost AND because it nurtures longer-term collaboration. The next time these partners think of a good idea, they won’t have to re-start the negotiations. They’ll be able to “start where they left off” so to speak.
We’ve seen that phenomenon in our alumni, who often say, “We did that one MAPH project, and other ideas just kept coming up!” One team from a county Animal Control Services Division several years ago worked with local veterinarians (initially seen as competitors) to build and staff a spay/neuter clinic in their community. Since then, they’ve established continuing educational programs for local veterinarians and their staff, created educational programs for local schools, partnered with pharmaceutical company that makes rabies vaccine, and worked with the local college pre-veterinary program whose students act as interns in the spay-neuter clinic, among other projects. In a way, once you start, it never ends!
I look forward to hearing more about interesting and exciting collaborations going on. And what about challenges you’ve found? What did you do about them?
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We are excited about a number of partnerships in Wilkes County. The one I want to discuss here is our Health Care Connection project which links about 2,500 uninsured adults to health care. This project would not be successful without the support of our local hospital, private providers including doctors and specialists, Care Connection Pharmacy, DSS, Blue Ridge Opportunity Commission, rural health clinics, local churches and other service providers such as optometrists. This project began as a MAPH business plan and continues to expand thanks to the passion of our community advocates which includes our Medical Director at the health department. We started the project with a grant through The Duke Endowment and are now fortunate to have a Health Net grant through the Office of Rural Health partnering with our Community Care Network. To make this project work, our partners donate services to make health care available to a qualified Health Care Connection patient from medications to x-rays to specialty care.
One of the barriers has been the lack of specialists in rural Wilkes County so some care is not available. Another barrier is those skeptics unwilling to participate. However, my faith in the ability of this community to find innovative solution to an urgent problem has been restored! It takes partnerships and collaborations.
How will the continuing decline in our economy affect us in the future? I know our need will continue to grow. We may have some partners stop participating. We may be forced to reinvent ourselves in a different way but the need is so great and we have so many with a passion to serve....
Hey, everyone -- that last post is from Ann Absher, a celebrated author from the Journal of Public Health Management and Practice special issue devoted entirely to the Management Academy (sept-oct, 2006), in which she and her co-author, Shirin Scotten, described the development and implementation of the Health Care Connection program in Wilkes County. Welcome to the site, Ann! It's great to hear about the success of your program. Others interested in the idea of "covering the uninsured" from the ground up should read their article.
As I contemplate a thesis and practicum for the MPH I am always aware of the unfair financial burden placed on Public Health. This has not made the issues I am interested in researching any easier. On a positive note, I know I can put together a presentable business plan to market ideas to the local health departments. One of my ideas uses accreditation and quality assurance as a carrot to introduce this type of collaboration to share resources here in rural eastern NC. I met with the Director of the NE Alliance while we were in Management Academy and hatched the idea. When I asked why we are the only area in NC that does not participate in the incubator program, I heard exactly what you are saying, skeptics to participation. It has taken me another year to consider an angle that might earn regional credibility. Any other tips or ideas to soften up the reluctance would be appreciated.
The other idea hasn't been researched enough to discuss.
Your comments focus on several major items of importance in North Carolina: Accreditation and the Incubator Collaboratives. The state has made great strides in each of these areas.
If anyone is unfamiliar with NC's Local Health Department Accreditation program and the Incubator Collaboratives see nciph.sph.unc.edu/accred
and
nciph.sph.unc.edu/incubator
It is a great idea to use the skills that you learned in the Management Academy to illustrate how to develop a sustainable project and the importance of partnerships and alliances to reach a common goal. Please continue to build on the idea that if we pool our resources and work together, we can be more successful at improving health outcomes for the residents of North Carolina. We wish you much success as you continue and if we can offer any assistance with your thesis, please let us know.
I attended the American Public Health Association (APHA) Annual Conference in October. There were of course many interesting sessions and I encourage some of you to share what you learned. One session that was interesting was the Management Issues for Local Public Health Officials: Investigating the Impact of Partnerships on Revenue Generating Strategies of Local Public Health Departments.
The presenter's research concluded that different types of partnerships influence the ability of a Local Health Department to generate more revenue. He indicated that partnerships with community health centers, federal government, universities, insurance companies and non-profit organizations tend to be associated with higher revenues.
His specific model did not provide evidence of a positive impact with other organizations, such as hospitals, doctors and some professional organizations.
In addition, to the comments already presented, please share some of your positive partnerships with organizations in your area.
I feel that this book provides a great foundation. With experience in dealing with urban health issues, I've applied this concept to the the issue of healthcare for the homeless. A Metropolitian public health business plan is ideal in addressing the health challenges. To simply just scratch the surface of regional health issues requires an active, diverse participant base. For example, the Dallas County metropolitian area has been home to the Metro Dallas Homeless Alliance (MDHA). There are approximately over 80 members who represent the following sectors:
* Cities
* Counties
* Homeless persons
* Business
* Medical & Social Service Agencies
* Interests groups and individuals
In the context of addressing healthcare for the homeless, I have observed the collaborative efforts that many communities have taken to combat this issue. A mulitude of partners from diverse backgrounds are joining forces throughout America to combact obstacles, birth new ideas, increase program budgets and to expand client outreach efforts. At the local level business plans to address healthcare issues related to the homelessness are usually referred to "the Continnum of Care Plan" or the 10-Year Plan to Ending Chronic Homelessnes (or some combination depending on the commuinty). The key component of these plans include service coordination, gap analysis, funding distribution, grant compliance and technical assistance. However, like all core components in the healthcare business plan assessment and strategic plans are also essential to addressing the complex issue of regional healthcare for the homeless. How are homeless veterans best served? Who funds these programs? Likewise, these alliances conduct a studies and surveys that are very similar to what is commonly referred to as a "market analysis". These alliances work to identify regional services agencies who provide dental services, detox, HIV/AIDS, pre-natal care and so on. In addition, these alliances are charged with the responisbility of identifying and prioritizing those healthcare service gaps that exist due to a lack of adequate community resouces needed to meet the healthcare for the homeless service demand on hand.
Moreover, leaders in Washington, DC has called upon local leaders throughout the country to develop and execute plans to eradicate chronic homelessness in ten years. This call for action, will continue to prompt a multitude of agencies to work together (who would typically compete for funds). These interest groups and agencies are now seeking out ways to maximize limited funding and leverage monetary/non-monetary resources, thus producing profitable partnerships. (Chapter 7 ) For example, in response to the outcry for services to meet the needs of the homeless population in the Dallas, Texas area, the Metro Dallas Homeless Alliance (MDHA) was developed to identify, address and resolve issues that contribute to the growing homeless population. MDHA has demonstrated both the need for healtcare for the homeless and the target market while being financially prudent (Chapter 6 and 12). MDHA has demontrated the need for such healthcare services via agency intake reports, surveys and direct interaction with the homeless. This information has provided the data to determine short-term and long-term goals as core components of the strategic action plan.
Over the years, organizations like MDHA have been critical to bringing the issues of healthcare for the homeless to the forefront across the United States. I expect that the devlopment of regional/metropolitan plans will continue to bring social service providers, housing providers (temporary, transitional, permanent, etc) and other key partners as listed above to contribute to the development of stronger catalystic collaborations, watering the grassroots, meeting the medical needs of the homeless populations across america. MDHA is only one example of how I predict that business plans will evolve into the public health arena. MDHA has achieved many milestones and yet there are more to tackle. Therefore, I feel that in many cases that such alliances will be propelled to take on more of the public health business plan model, especally in the areas of project operations, evaluations and financial planning in order to sustain in the emerging economy.
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