Exploring the Value of Prevention 2018 Grantees

This project will examine the relationship between state spending (health services, social services, criminal justice and education) and health outcomes and the degree to which public spending effectively improves community health and well-being. It will produce a series of publications, spanning two budget cycles, that address whether the redistribution of spending priorities could lead to more positive community outcomes. It will also develop analytical products in response to emerging federal policies and regulations and host at least one forum to engage policymakers, advocates, funders, other community leaders, and the media in health and other equity issues.

Partners: Bay Area Domestic Violence Shelter Collaboration, 13 Domestic Violence shelters from seven Bay area counties, Criterion Institute and Rise together Bay Area, Leadership for Equity & Opportunity

This project will design strategies to use finance to create gender-equitable social change. Project collaborative members will participate in a learning-in-action program to develop resources to build systemic change through long-term prevention. Following this program, participants will receive technical assistance to design and develop new revenue strategies to establish a long-term prevention plan geared toward systemic change. This project will also explore options for replicable financial models that generate new revenue for prevention programming, including divestment from investments that promote or condone violence against women, the development of a social bond investing model or similar strategy to generate new revenue to prevent violence against women and reduce social costs; engaging local governments, community foundations, and corporations in divesting and re-investing in the new financial model; and creating momentum and messaging for the project by telling the story of violence against women, which illustrates how existing financial systems support violence against women.

Partners: SmartAirLA, Los Angeles County Department of Public Health, City of Los Angeles Information Technology Agency and Department of Neighborhood Empowerment, Adherium Corporation, University of Southern California Keck School of Medicine, Department of Preventive Medicine and University of California Los Angeles Geffen School of Medicine, Medical Imaging Informatics Group

This project will empower communities to utilize data to systematically improve the environmental and social conditions associated with asthma, and have a direct impact on chronic illness in their communities. This project will develop a pay for success (PFS) model that mobilizes impact capital to fund the community-based deployment of 150 GPS-enabled “smart inhalers” to underserved asthmatic children in Los Angeles County. With guidance from the Asthma Coalition of Los Angeles County and the Los Angeles County Department of Public Health, SmartAirLA will partner with health care providers in communities afflicted by pollution to provide the smart inhalers to asthmatic children over the 12-month pilot period. UCLA Children’s Hospital Pediatric Asthma Center will measure the health outcomes from the smart inhaler use. The PFS model will earn an annual financial return on investment from health care payers, such as Medicaid, based on the cost savings generated by the reduction in asthma hospitalizations. The City of Los Angeles Information Technology Agency and Department of Neighborhood Empowerment, and the Advancement Project will advise on the creation of a citizen science data dashboard that collects asthmatic hotspots data and layers on pollution and social economic data. The project will equip community groups and organizers to use that data to advocate for change—shifting asthma as a private condition managed between patient and provider to an issue that we as a community can do something about.

Partner: Sacramento Minority Youth Violence Prevention Collective

This project will explore ways to define and measure the value of resilience strategies across multisector groups, how inequity, vulnerability, and power imbalances influence this value proposition; and how community voices can be authentically brought into the discussion of value. As lead agency for the Sacramento Minority Youth Violence Prevention Collective, Health Education Council will convene members to understand the concept of value and its role in violence prevention, explore the root causes of violence in Sacramento, evaluate techniques for measuring value, and develop a shared value proposition for resilience and violence prevention. This project will contribute to the understanding of how to better generate investments in resilience and violence prevention. This will include a set of community-based research methods that engage community leaders and residents in the exploration of the concept of value and its relationship to trauma, resilience, violence prevention, and meaningful systems change.

Partners: Minga Analytics, California Accountable Communities for Health Initiative

This project will develop and test a set of financial and non-financial valuation approaches for multisector strategies and initiatives. This will include strategic engagement with the people who implement multisector initiatives; a review of existing valuation tools; the development of a guided process, tools, and recommendations to identify key outcome values; the completion of test valuations, and producing, refining and disseminating case studies. This project will enable local initiative leaders to better analyze and communicate the value of their prevention work; increase awareness in the field about the value of practical valuation approaches for prevention activities, resulting in a meaningful contribution to the library of valuation tools and examples.

Partner: California Consortium on Urban Indian Health

This project and its member health centers, will advance a community-based participatory research effort to further define and support the recognition and value of Native American culture as a social determinant of health, an important program objective, and a viable outcome measure.. This project follows phase 4 of the Culture is Prevention study that validated the Cultural Connectedness Scale’s (CCS) ability to link culture and well-being. In this phase, researchers will explore the predictive properties of the CCS with respect to other health and social risks like depression, chronic disease, domestic violence, and life satisfaction. Results of this study will be disseminated throughout the state and nation to influence practice and policy change.

This project will identify new financial structures and policies that promote healthy housing and reduce housing-related disparities. It will assess the current financing landscape for healthy housing, how funds are administered and the human and social costs of the inefficient use of resources. It will also identify potential solutions, such as opportunities for braided or coordinated funding in local jurisdictions to better serve residents through a more comprehensive approach and identify state policy levers to improve coordination. These analyses will lead to a series of policy recommendations to effectively utilize healthy housing investments for community-centered strategies.

Partners: The Low Income Investment Fund, The Local Initiatives Support Corporation, The Nonprofit Finance Fund, Enterprise Community Partners

This project will support partnerships between health care and community development finance institutions (CDFIs) in four California communities, advance the implementation of collaborative projects, and generate learnings on how to leverage community development and health care for sustainable investments in health and well-being. It will help CDFIs establish working relationships with health care partners by assisting with outreach, meeting facilitation, and action planning. It will also build a foundation for partnership and support each community to initiate a collaborative project with shared goals. A key piece of this work will be to surface value propositions for partnerships between CDFIs and health care partners and with other key stakeholders and institutions.

Partners: University of California, Berkeley, Haas School of Business and University of Chicago, Chapin Hall

This project will analyze the economic burden of child abuse in California on a statewide and county-by-county basis. The project partners will evaluate the aggregate community risk and protective factors related to child abuse, assign economic value using a cost calculator, package the findings into state and county profiles with complementary messages and collateral, and disseminate to key state and county stakeholders. They will also conduct a deeper analysis of the costs of child welfare in three counties in California. These activities will provide communities with the tools to articulate the value of prevention and advocate for policies and strategies to reduce the individual and social impact of abuse.

Partners: Center for Health Care Strategies, Public Health Institute, Health in All Policies Program

This project will enable the government to buy better health outcomes by translating the core principles underlying the Pay for Success movement into terminology and tools that can be plugged into the existing policymaking process. This will include a framework for defining, assessing, and pricing the value of prevention in promoting community well-being, trainings to disseminate the approach, and in-person diagnostic clinics to jumpstart performance-based payment approaches for health. In one statewide priority area, the project will use this framework to analyze and make recommendations around outcomes-based procurement for better population health.

Partners: The Strategies Center, First 5 Placer

This project will develop a system to measure the qualitative and quantitative value of prevention at the local level to increase collaborative efforts and prevention funding. It will expand the First 5 Placer collaborative’s work, illustrating the geographic distribution of child maltreatment and the social determinants of health by mapping domestic violence incidence in Placer County. Project goals are to illustrate the intersection between domestic violence, child abuse, and other social determinants of health; to assess how these issues inform prevention; and to create a framework to measure its value. This project will expand the understanding of family violence, by adding a layer of domestic violence data to the family health and well-being indicators being investigated countywide, and will result in data that can be used to advocate for the inclusion of domestic violence prevention in the collaborative funding framework to generate sustainable funding.

Partner(s): Mental Health America

This project will partner with Mental Health America to design alternative payment models (APMs) with a focus on early childhood and lifecourse approaches. It will conduct interviews with 8-10 community collaborations and an advisory committee of experts in health care financing on the implementation of APMs using an early childhood bundled payment model. It will develop a proposal for four APM designs as well as examples of sites that represent progress toward the new types of models. It will use these findings as the foundation for a design process that will include a convening of cross-disciplinary set of experts and community collaborations to identify legal, financial, and data integration challenges and opportunities, measurable benefits, and optimal strategies leading toward the implementation of the new APMs.

Partner: California Accountable Communities for Health Initiative

This project will develop financing strategies to benefit multisector partnerships that improve community health. It will evaluate the California state and local funding streams and produce a funding matrix. It will also prioritize one funding stream and up to two use cases to demonstrate the value of new public sector investments in prevention and population health. By the end of the project, communities will have a roadmap for public funding options for population health and be able to use, as an example, at least one new use case that can be scaled statewide.

Partners: Rise Together Bay Area, California Forward, Applied Survey Research, Sonoma County Upstream Investments Initiative

This project will work with innovative Bay Area leaders to assess the current successes and limitations of upstream investments in housing, early care, and employment—to develop strategies to change policies and practices to improve economic security, public health, and well-being. The project will work with multiple stakeholders representing a diverse range of input from Bay Area counties to identify breakthrough strategies and next steps that can be taken within and among local governments, as well as the local and state policy choices that would enable transformational upstream investments and systems change. This information will be used to develop a framework with specific recommendations for practice, policy, and administration that build internal capacity and external pressure for investments that promote economic security, prevent violence, and contribute to greater community wellbeing.

This project will quantify the cost savings generated by the integration of publicly-funded mental health and health benefits, and any cost savings resulting from early intervention and diversion from child welfare or mental health services. It will also demonstrate how a system of integrated health assessments in public benefits programs can positively impact clients by providing an early access point to the full array of health support services that clients are entitled to through Medi-Cal. It will improve the referral process and identify mental health service gaps in managed care plans. It will also develop and propose policy solutions to advance an efficient, integrated assessment and referral system, linking clients to health services and a permanent source of funding.

Partners: Robert Wood Johnson Foundation, Federal Reserve Bank of San Francisco, Nonprofit Finance Fund, ReThink Health

This project will support three leaders in the Robert Wood Johnson Culture of Health Leaders program to support the creation, fund development and launch of a Social Impact Fund to support the long-term horizon for outcomes-based funding. Leaders will convene stakeholders to explore a 2040 vision for outcomes-based funding and publish and disseminate an investing futures report that includes an analysis, scenario paper, and network development strategy for the long-term horizon for outcomes-based funding. They will develop up to two rate cards relevant to California communities. In addition, they will develop governance and operations policies, and create the legal entities to operationalize the fund. The fund will be marketed to potential public and private funders, with the goal of raising $200 million by 2025 to scale and expand the Fund. Development of a five-year strategic plan will support the ongoing operations, vision, and direction of the Fund.