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BMC Public Health
Published in: BMC Public Health 1/2024

Open Access 01-12-2024 | Research

A collaboration team to build social service partnerships within a safety-net health system

Authors: Savanna L. Carson, Francesca Cameron, Diamond Lee, Diana Zúñiga, Kelli Poole, Adjoa Jones, Cristina Herman, Mayra Ramirez, Simone Harlow, Jeannette Johnson, Etsemaye P. Agonafer, Clemens S. Hong, Arleen F. Brown

Published in: BMC Public Health | Issue 1/2024

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Abstract

Background

To facilitate safety-net healthcare system partnerships with community social service providers, the Los Angeles County Department of Health Services (LAC DHS) created a new collaboration team to spur cross-agency social and medical referral networks and engage communities affected by health disparities as part of a Sect. 1115 Medicaid waiver in Los Angeles County entitled Whole Person Care-Los Angeles (WPC-LA).

Methods

This observational research reviews three years of collaboration team implementation (2018–2020) through Medicaid-reportable engagement reports, a collaboration team qualitative survey on challenges, facilitators, and recommendations for community engagement. Member reflections for survey findings were conducted with the collaboration team and LAC DHS WPC-LA leadership.

Results

Collaboration team Medicaid engagement reports (n = 144) reported > 2,700 events, reaching > 70,000 individuals through cross-agency and community-partnered meetings. The collaboration team survey (n = 9) and member reflection sessions portrayed engagement processes through outreach, service assessments, and facilitation of service partnerships. The collaboration team facilitated community engagement processes through countywide workgroups on justice-system diversion and African American infant and maternal health. Recommendations for future safety net health system engagement processes included assessing health system readiness for community engagement and identifying strategies to build mutually beneficial social service partnerships.

Conclusions

A dedicated collaboration team allowed for bi-directional knowledge exchange between county services, populations with lived experience, and social services, identifying service gaps and recommendations. Engagement with communities affected by health disparities resulted in health system policy recommendations and changes.
Literature
1.
Fichtenberg C, Delva J, Minyard K, Gottlieb LM. Health And Human Services Integration: Generating Sustained Health And Equity Improvements: An overview of collaborations, partnerships, and other integration efforts between health care and social services organizations. Health Affair. 2020;39(4):567–73.CrossRef
2.
3.
Berwick DM, Nolan TW, Whittington J. The triple aim: care, health, and cost. Health Affair. 2008;27(3):759–69.CrossRef
4.
Bachrach D. Addressing patients' social needs: an emerging business case for provider investment. Commonwealth Fund; 2014.
5.
Horwitz LI, Chang C, Arcilla HN, Knickman JR. Quantifying Health Systems’ Investment In Social Determinants Of Health, By Sector, 2017–19: Study analyzes the extent to which US health systems are directly investing in community programs to address social determinants of health. Health Affair. 2020;39(2):192–8.CrossRef
6.
National Academies of Sciences E, Medicine. Integrating social care into the delivery of health care: Moving upstream to improve the nation's health. 2019.
7.
Kreuter MW, Thompson T, McQueen A, Garg R. Addressing social needs in health care settings: evidence, challenges, and opportunities for public health. Annu Rev Public Health. 2021;42:329.CrossRefPubMedPubMedCentral
8.
Wodchis WP, Shaw J, Sinha S, Bhattacharyya O, Shahid S, Anderson G. Innovative Policy Supports For Integrated Health And Social Care Programs In High-Income Countries: An evaluation of innovative policy supports to provide integrated health and social care to high-needs and high-cost populations in high-income countries. Health Affair. 2020;39(4):697–703.CrossRef
9.
Mullins CD, Wingate LMT, Edwards HA, Tofade T, Wutoh A. Transitioning from learning healthcare systems to learning health care communities. J Comp Eff Res. 2018;7(6):603–14.CrossRefPubMed
10.
Chuang E, Pourat N, Haley LA, O’Masta B, Albertson E, Lu C. Integrating Health And Human Services In California’s Whole Person Care Medicaid 1115 Waiver Demonstration: An overview of a California demonstration program focused on improving the integrated delivery of health, behavioral health, and social services for certain Medicaid beneficiaries. Health Affair. 2020;39(4):639–48.CrossRef
11.
12.
13.
14.
Kim K, Choi JS, Choi E, et al. Effects of community-based health worker interventions to improve chronic disease management and care among vulnerable populations: a systematic review. Am J Public Health. 2016;106(4):e3–28.CrossRefPubMedPubMedCentral
15.
O’Brien BC, Harris IB, Beckman TJ, Reed DA, Cook DA. Standards for reporting qualitative research: a synthesis of recommendations. Acad Med. 2014;89(9):1245–51.CrossRefPubMed
16.
King O. Two sets of qualitative research reporting guidelines: An analysis of the shortfalls. Res Nurs Health. 2021;44(4):715–23.CrossRefPubMed
17.
Berkowitz B. Collaboration for health improvement: models for state, community, and academic partnerships. J Public Health Man. 2000;6(1):67–72.
18.
Milstein B, Wetterhall S. Recommended framework for program evaluation in public health practice. Morbidity and Mortality Weekly Report: Recommendations and Reports Series. 1999.
19.
Braun V, Clarke V. Reflecting on reflexive thematic analysis. Qual Res Sport Exerc Health. 2019;11(4):589–97.CrossRef
20.
Braun V, Clarke V. One size fits all? What counts as quality practice in (reflexive) thematic analysis? Qual Res Psychol. 2021;18(3):328–52.CrossRef
21.
Braun V, Clarke V. Toward good practice in thematic analysis: Avoiding common problems and be (com) ing a knowing researcher. Int J Trans Health. 2023;24(1):1–6.CrossRef
22.
Tracy SJ. Qualitative quality: Eight “big-tent” criteria for excellent qualitative research. Qual Inq. 2010;16(10):837–51.CrossRef
23.
González R. The Spectrum of Community Engagement to Ownership. Facilitating Power, Oakland, CA: Movement Strategy Center; 2019.
24.
Schoch-Spana M, Franco C, Nuzzo JB, Usenza C, Working Group on Community Engagement in Health Emergency P. Community engagement: leadership tool for catastrophic health events. Biosecur Bioterror. 2007;5(1):8–25.CrossRefPubMed
25.
26.
Jones K, Okun T. White supremacy culture. Dismantling racism: A workbook for social change groups. 2001.
27.
Coskun A, Erbuğ Ç. User diversity in design for behavior change. 2014:546–559.
28.
Wijeyesinghe C, Jackson BW. New perspectives on racial identity development: Integrating emerging frameworks. NYU Press; 2012.
29.
30.
Nelson J, Spokane L, Ross L, Deng N. Advancing Racial Equity and Transforming Government: A Resource Guide to Put Ideas Into Action Government Alliance on Race and Equity (GARE);2015.
31.
Lohrentz T. Contracting for Equity: Best Local Government Practices that Advance Racial Equity in Government Contracting and Procurement. Government Alliance on Race & Equity (GARE);2015.
32.
Nelson J, Tyrell S. Public Sector Jobs: Opportunities for Advancing Racial Equity. Government Alliance on Race and Equity (GARE);2015.
33.
Curren R, Nelson J, Marsh DS, Noor S, Liu N. Racial Equity Action Plans: A How-to Manual. Government Alliance on Race and Equity (GARE);2016.
34.
Keleher T. Racial Equity Core Teams: The Engines of Institutional Change. Government Alliance on Race and Equity (GARE);2018.
35.
36.
Bromley E, Figueroa C, Castillo EG, et al. Community Partnering for Behavioral Health Equity: Public Agency and Community Leaders’ Views of its Promise and Challenge. Ethn Dis. 2018;28(Suppl 2):397–406.CrossRefPubMedPubMedCentral
37.
Ward CJ, Child C, Hicken BL, et al. “We Got an Invite into the Fortress”: VA-Community Partnerships for Meeting Veterans’ Healthcare Needs. Int J Environ Res Public Health. 2021;18(16):8334.CrossRefPubMedPubMedCentral
38.
Amarashingham R, Xie B, Karam A, Nguyen N, Kapoor B. Using community partnerships to integrate health and social services for high-need, high-cost patients. Issue Brief (Commonweath Fund). 2018;2018:1–11.
39.
Taylor LA, Byhoff E. Money moves the mare: the response of community-based organizations to health care’s embrace of social determinants. Milbank Q. 2021;99(1):171–208.CrossRefPubMedPubMedCentral
40.
Lanford D, Petiwala A, Landers G, Minyard K. Aligning healthcare, public health and social services: A scoping review of the role of purpose, governance, finance and data. Health Soc Care Community. 2022;30(2):432–47.CrossRefPubMed
41.
Zahner SJ. The mobilizing action toward community health partnership study: multisector partnerships in US counties with improving health metrics. Prev Chronic Dis. 2014;11:E05.CrossRefPubMedPubMedCentral
42.
Woulfe J, Oliver TR, Siemering KQ, Zahner SJ. Peer reviewed: Multisector partnerships in population health improvement. Prev Chronic Dis. 2010;7(6).
43.
Siegel B, Erickson J, Milstein B, Pritchard KE. Multisector partnerships need further development to fulfill aspirations for transforming regional health and well-being. Health Affair. 2018;37(1):30–7.CrossRef
44.
Agonafer EP, Carson SL, Nunez V, et al. Community-based organizations’ perspectives on improving health and social service integration. BMC Public Health. 2021;21(1):452.CrossRefPubMedPubMedCentral
45.
Sandhu S, Sharma A, Cholera R, Bettger JP. Integrated Health and Social Care in the United States: A Decade of Policy Progress. Int J Integr Care. 2021;21(4):9.CrossRefPubMedPubMedCentral
46.
Sacks E, Morrow M, Story WT, et al. Beyond the building blocks: integrating community roles into health systems frameworks to achieve health for all. BMJ Glob Health. 2019;3(Suppl 3):e001384.CrossRefPubMedPubMedCentral
47.
Castrucci B, Auerbach J. Meeting individual social needs falls short of addressing social determinants of health. Health Affairs Blog. 2019;10.
48.
Durfey SN, Gadbois EA, Meyers DJ, Brazier JF, Wetle T, Thomas KS. Health Care and Community-Based Organization Partnerships to Address Social Needs: Medicare Advantage Plan Representatives’ Perspectives. Med Care Res Rev. 2021;79(2):10775587211009724.
49.
Hardin L, Trumbo S, Wiest D. Cross-sector collaboration for vulnerable populations reduces utilization and strengthens community partnerships. J Interprofessional Educ Pract. 2020;18:100291.CrossRef
50.
Nathan S, Harris E, Kemp L, Harris-Roxas B. Health service staff attitudes to community representatives on committees. J Health Organ Manag. 2006;20(6):551–9.CrossRefPubMed
51.
Costa-Font J, Forns JR, Sato A. Participatory health system priority setting: Evidence from a budget experiment. Soc Sci Med. 2015;146:182–90.CrossRefPubMed
52.
Noonan AS, Velasco-Mondragon HE, Wagner FA. Improving the health of African Americans in the USA: an overdue opportunity for social justice. Public Health Rev. 2016;37(1):1–20.CrossRef
53.
Almgren G. Health care politics, policy, and services: a social justice analysis. Springer publishing company; 2017.
54.
Kania J, Williams J, Schmitz P, Brady S, Kramer M, Juster JS. Centering equity in collective impact. Stanf Soc Innov Rev. 2022;20(1):38–45.
55.
Chuang E, O’Masta B, Albertson E, Haley L, Lu C, Pourat N. Policy Brief: Whole Person Care Improves Care Coordination for Many Californians Los Angeles: UCLA Center for Health Policy Research;2019.
56.
American Association of Medical Colleges. The Principles of Trustworthiness. American Association of Medical Colleges. Published 2021. Accessed 8 Apr 2022.
57.
Parker E, Margolis LH, Eng E, Henriquez-Roldan C. Assessing the capacity of health departments to engage in community-based participatory public health. Am J Public Health. 2003;93(3):472–6.CrossRefPubMedPubMedCentral
58.
Los Angeles County Alternatives To Incarceration Workgroup. Care First, Jails Last: Health and Racial Justice Strategies for Safer Communities Chief Executive Office, County of Los Angeles;2020.
59.
60.
61.
Tchekmedyian A. L.A. County seeks plan to close aging Men’s Central Jail in a year. Los Angeles Times. 7Jul 2020 2020.
62.
63.
Los Angeles County Executive Office, Los Angeles County Board of Supervisors, Los Angeles County Counsel, Los Angeles County Measure J Advisory Panel Chair, Los Angeles County Alternatives To Incarceration Workgroup, Los Angeles County Anti-Racism Diversity and Inclusion. Financial Year 2021–2022 Measure J Recommended Set-Aside. Los Angeles County, CA: Los Angeles County Executive Office;  2021.
64.
65.
Metadata
Title
A collaboration team to build social service partnerships within a safety-net health system
Authors
Savanna L. Carson
Francesca Cameron
Diamond Lee
Diana Zúñiga
Kelli Poole
Adjoa Jones
Cristina Herman
Mayra Ramirez
Simone Harlow
Jeannette Johnson
Etsemaye P. Agonafer
Clemens S. Hong
Arleen F. Brown
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-024-18155-z

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