By 露西·佩格尔, 梅根·托马斯。, 谭雅施瓦兹贝瑟妮·斯奈德
近年来, there has been an increasing emphasis on improving health outcomes by addressing the social determinants — the environmental and social conditions, 比如获得安全和经济适用的住房, 教育和就业机会, 良好的营养会影响人们的整体健康.
而孤立的项目和资金流, 优先级的冲突, and lack of coordination and communication across agencies have historically impacted the ability of public programs to work together effectively to address social determinants, 全国各地的医疗补助计划正开始应对这一挑战.
在过去几年里, Harbage咨询有 supported clients in implementing innovative Medicaid initiatives that address the social determinants in an effort to improve health outcomes.
Below are a few examples of programs we have been proud to contribute to that link people to the social supports they need to lead healthier lives.
加州的 全人关怀计划 由25名飞行员组成，他们负责协调身体健康, 行为健康, 为加州医保受益人提供社会服务, 县实体, 和社区组织. 的 WPC pilots are addressing the social determinants of health by connecting individuals to health care, 住房, 以及全方位的社区资源和社会服务. Here are some of the ways WPCs are connecting members to services beyond the traditional health care system:
- 住房: Pilots with a focus on their community’s homeless population are coordinating physical and 行为健康 services and addressing 住房 instability by providing tenancy support services. 这可以包括:帮助寻找住房, 协助处理房东关系, 法律咨询, 押金和第一个月的租金, 教育资源, 和更多的.
- 社会服务: Some pilots are helping their enrollees connect to other social services like Supplemental Security Income (SSI), CalFresh(食品券), 以及县管理的一般援助/救济项目.
- 再入/ Justice-Involved: Pilots that are targeting individuals recently released from incarceration are providing enhanced care coordination services and working closely with their local law enforcement, 修正, 和/或缓刑部门，以促进再入职程序. 目标是将成员与所需的健康联系起来, 心理健康, and social services immediately upon release without experiencing a lapse in care. 飞行员已经在试用部门设立了办公室, 派遣护理协调员在个人获释或在法庭听证会上会见他们, 并激励提供者在发布前进行评估.
的 WPC pilots are testing innovative strategies for addressing the social determinants of health. Harbage Consulting is helping to spread pilots’ innovative ideas and address challenges by facilitating the WPC Learning Collaborative on behalf of the California Department of Health Care Services (DHCS).
B 'More for Healthy Babies
In 2009, Baltimore City had one of the highest infant mortality rates in the country. 那一年，这座城市启动了 B 'More for Healthy Babies (BHB), a public-private partnership led by the Baltimore City Health Department that provides high-quality, coordinated maternal and infant health services and support to first-time and high-risk mothers during pregnancy and after the baby is born.
BHB is a comprehensive strategy designed to address the social determinants of health that influence birth outcomes in Baltimore. Pregnant women and new mothers receive support in their communities – including at neighborhood mom’s clubs, 母乳喂养支援小组, and B’More Fit exercise classes – as well as through home visits during and after pregnancy. 自2009年实施BHB以来, 该市的婴儿死亡率从13%下降了35%.2009年至2009年，每千名活产死亡5人 8.8 in 2016. Harbage咨询有 支持巴尔的摩市卫生局 with identifying opportunities for long-term sustainability of BHB including connecting more effectively to Medicaid.
的 加州健康之家计划 (HHP) is designed to connect Medi-Cal patients with multiple chronic conditions and/or a serious mental illness to an enhanced set of care management and coordination services. One of the core services provided under the HHP is ensuring that patients are connected to community resources and social service agencies that help them address their non-medical needs, 比如参加营养计划, 就业培训, 和法律服务. 的 HHP also places a strong emphasis on connecting patients to 住房 and transportation supports, 因为这些是改善健康的主要障碍. 的 HHP is in its early stages and Harbage Consulting is supporting DHCS with program design and implementation. This includes policy analysis as well as developing communication and outreach materials for providers, 加州医保成员, 和社区组织.
约 在美国，五分之一的学龄儿童.S. 视力有问题, and low-income and minority children are disproportionately likely to have unmet vision needs. Uncorrected vision can have numerous health and social consequences — including poor school performance and interference with emotional development — which perpetuate long-standing disparities in low-income communities. Glasses are an easy way to improve vision quickly and can positively impact academic and lifetime achievement.
哈贝奇咨询公司提供政策和法律分析, 以及运营和通信支持, 到全国非营利组织 视觉学习 自2016年以来(VTL). 视觉学习 provides eye examinations and glasses to public school students through mobile clinics on-site, 不让家庭付出任何代价. 我们的团队一直致力于支持加州洛杉矶的虚拟带库项目， 马里兰州巴尔的摩密歇根州底特律市和北卡罗来纳州夏洛特市. We are proud of our work to support children’s access to vision care and to promote the long-term sustainability of this effort to advance health equity across the country.
Addressing the wide range of social determinants of health is a new frontier in the world of health program administration. Harbage Consulting is excited to provide our expertise in Medicaid policy and financing to help our clients discover opportunities to address the social determinants of health through Medicaid and other social service initiatives. 我们希望通过这项工作, we can play a part in reducing health disparities and improving health outcomes across the county.