Successful Partnerships Between Human Service Nonprofits and Healthcare Organizations
By: Somya Mohindra
The novel coronavirus has emphasized the effect of social determinants on health outcomes. In Chicago, over 50% of COVID-19 cases and 70% of fatalities occur within the Black population, which comprises only 30% of the Chicago population. A Boston study found that 36% of homeless individuals in a given shelter tested positive for COVID-19 as a result of crowded living spaces. Race, homelessness, poverty, smoke exposure, and food insecurity are therefore all associated with more severe COVID-19 symptoms and overall health outcomes.
Due to these social determinants, quality and consistency of care remains uneven across U.S. populations despite growing medical expenses. The 2010 Affordable Care Act (ACA) addressed outcome disparities and brought low-cost healthcare to vulnerable populations by creating programs like the Delivery System Reform Incentive Payment Program, which stresses the use of both health and human services in patient treatment plans. While the future of the ACA is unclear, the act catalyzed thousands of strong cross-sector community partnerships that will continue to expand their impact regardless of U.S. healthcare policy. In this article, we highlight three successful partnerships that demonstrate how unifying the human service and healthcare sectors can transform population health in the U.S.
The California Food Is Medicine Coalition
This collaboration across six California nonprofit organizations (Project Open Hand — San Francisco, Ceres Community Project — North Bay, Food for Thought — North Bay, Health Trust — San Jose, Project Angel Food — Los Angeles, Mama’s Kitchen — San Diego) and California’s Medicaid program delivers medically-tailored meals to the homes of chronically ill Medi-Cal patients. This program acknowledges the importance of strong nutrition to patient healing and stability. The individualized and home-delivered meal plans remove barriers to getting proper nutrition, including affordability, availability, and physical access.
Prior to the development of this coalition, Project Open Hand collaborated with UCSF medical center to provide medically tailored meals for San Francisco and Alameda County residents with Type 2 Diabetes or HIV. The Journal of Urban Health reported a 63% drop in hospitalizations, 50% increase in medication adherence, and a 58% drop in E.R. visits as a result of this work. The incredible success of this program led to its integration with the California government and other nonprofits under the name CalFIMC.
Project Open Hand’s pilot program granted CalFIMC the blueprint and feedback necessary to improve patient satisfaction. Using this information and resources pooled from mission-aligned community organizations, dedicated healthcare partners, and prominent government sponsors, CalFIMC was able to reach Medi-Cal patients beyond the Bay Area. It may even serve as a future model for nutrition therapy across the country.
The Greater Portland Addiction Collaborative
The Greater Portland Addiction Collaborative (GPAC) consists of local hospitals, The City of Portland, Portland Police Department, housing and employment providers, recovery providers, crisis managers, and community centers working to provide comprehensive care to uninsured people with substance abuse issues in Portland, Maine. This collaborative acknowledges that housing, employment, and other social determinants of health must be addressed along with traditional primary care needs in order to curb the opioid epidemic.
The GPAC lowers costs for providers, taxpayers, and patients while filling in the gaps of traditional healthcare treatment. The partnership model coordinates care at hospital discharge, increases capacity of the detoxification center, and integrates addiction services for patients within Mercy Hospital, Maine Health, and Greater Portland Health. As a result of this collaboration, these hospitals built 48 housing pods with social service support in the form of recovery programming, peer support, and employment services, all provided by partner community organizations. 58% of recovering women who entered these transitional housing pods enrolled in higher education. Furthermore, in 2015, the collaborative saved patients $1.3 million in medical bills and led 444 patients to secure health insurance and a medical home.
The success of this collaboration can be attributed to its clear mission statement, which was formulated using a 2016 community health needs assessment conducted by Maine’s Center of Disease Control and Prevention and four other local health systems. The data-driven agreement on program priorities allowed for the development of specific short and long-term goals. Moreover, there is strong communication across all organizations, facilitated by exceptional resource and data-sharing practices. Open Lattice, a cloud-based data-integration platform, developed a patient records portal for all GPAC partners, who were previously using paper-tracking methods. Open Lattice and GPAC partners worked together to inform data cleaning practices, sign privacy agreements, and optimize workflows. This platform streamlines the patient referral process and allows for impact evaluation, which has led to increased funding and the refining of care delivery pipelines.
The Ruth Ellis Health & Wellness Center
This collaboration between the Ruth Ellis Center (REC), a nonprofit youth social services organization, and the Henry Ford Health System (HFHS), a healthcare organization, seeks to meet the health and social service needs of Detroit’s young LGBTQ+ community. The integrated physical, behavioral, and social programming is delivered from a newly constructed Ruth Ellis Health & Wellness Center, which is managed by the Ruth Ellis Center. The safe, designated space allows LGBTQ+ youth to access a breadth of care in a single visit as both organizations provide swift referrals to the other’s services. HFHS’s services include HIV/AIDS testing, sexual health services, and transition medication and hormone therapy. REC’s team provides assistance with housing instability, domestic violence, food insecurity, mental health, substance abuse, and employment training.
This collaboration allowed HFHS to expand the reach of its primary care services and medical expertise within the target community, which was previously not taking advantage of medical services due to distrust in the medical system. REC brought the cultural competency and community contacts needed for HFHS to realize its largest impact on LGBTQ+ youth. Due to this partnership, the Ruth Ellis Health & Wellness Center is able to both serve more patients and cut costs. The success of this collaboration can be attributed to well-defined roles and responsibilities, clear goals, and a strong understanding of each organization’s strengths.
