D776 Task 2 Strategic Partnership Plan Example

A Housing Authority and the Hospital's Own Neighbors: Two New Partnerships for Health and Behavioral Health in the East River District

Student Name

Leavitt School of Health, Western Governors University

D776: Healthcare Leadership and Community Engagement, Task 2

Course Instructor

Month Day, Year

A Housing Authority and the Hospital's Own Neighbors: Two New Partnerships for Health and Behavioral Health in the East River District

The Needs the Partnerships Address

Millbrook Medical Center's Task 1 analysis identified the sociopolitical drivers behind the East River district's poor health and behavioral health outcomes: low health literacy, economic insecurity, gaps in school and workplace support, lack of insurance and an underfunded crisis system. Many of the district's highest-need residents live in three public housing developments near the hospital, which together account for about 18% of the hospital's emergency visits for diabetes complications and behavioral health crises. At the same time, about a third of Millbrook's hourly employees live in the district, yet the hospital has never asked them to help shape its community work. This plan proposes two new relationships: a strategic partnership with the city's public housing authority, and a new form of engagement with an organizational stakeholder, the hospital's own employees who live in East River.

Distinguishing Partner From Stakeholder

A strategic partner is an outside organization that brings resources, reach or authority the hospital lacks and works with it toward shared goals under an agreement. An organizational stakeholder is a group with a direct interest in the hospital itself, such as employees, physicians, patients or board members. Millbrook already refers patients to many community agencies and surveys its employees each year; neither of the relationships below exists today, and both go beyond referral or consultation to shared work.

Strategic Partner: The Public Housing Authority

Purpose. The partnership would establish a health hub in the community rooms of the three housing developments, staffed by two Millbrook community health workers, a part-time nurse and a licensed behavioral health counselor, and supported by the housing authority's resident services staff. The hub would offer blood pressure and glucose checks, help with medications and appointments, short-term counseling and linkage to treatment for substance use, and screening for food, benefit and legal needs.

What each side gains. Residents gain care where they live, from staff they come to know. The housing authority gains support for residents whose health or behavioral health crises threaten their tenancy, fewer emergency calls and a stronger case for federal and state funding for resident services. Millbrook gains fewer avoidable emergency visits and admissions, better chronic disease control among patients who are hard to reach, and a credible community benefit program. Evidence supports this model: in a randomized trial among low-income patients, those supported by community health workers who addressed social needs spent substantially fewer total days in the hospital at six and nine months and were more likely to rate their care as high quality (Kangovi et al., 2018). A systematic review of interventions addressing patients' social and economic needs found that many reported positive effects on health outcomes, although the quality of the evidence varied (Gottlieb et al., 2017).

Structure and governance. A memorandum of understanding would define each side's contributions: the housing authority provides space, utilities and resident outreach; Millbrook provides staff, supplies and clinical oversight. A joint steering committee including two residents would meet quarterly. A data sharing agreement, reviewed by both organizations' counsel, would allow aggregate reporting on emergency visits and admissions among consenting residents while protecting privacy.

Measures. Residents enrolled with the hub; emergency visits and admissions among enrolled residents compared with the prior year; share of enrolled residents with diabetes whose blood sugar is controlled; referrals completed to behavioral health treatment; and evictions linked to health or behavioral health crises.

Organizational Stakeholder: Employees Who Live in East River

Purpose. Millbrook would create a paid Neighborhood Health Ambassador role for employees who live in the district: environmental services staff, nursing assistants, food service workers and clerks. Ambassadors would receive 40 hours of training in health literacy, mental health first aid, naloxone and navigating the hospital's services, and would have four paid hours a month to lead conversations at churches, schools and community events, gather residents' concerns and serve on the hospital's community health committee.

What each side gains. The community gains trusted messengers who share residents' language and experience, which matters for topics such as depression and substance use that people are reluctant to raise with strangers. Employees gain recognition, skills, a new career path toward community health work and a voice in decisions about their own neighborhood. Millbrook gains insight it cannot get from surveys, stronger relationships in the district and a way to improve retention among hourly staff, whose turnover is costly. The approach builds on the Task 1 finding that institutions residents already trust, such as schools, extend a hospital's reach further than its own clinics can (Knopf et al., 2016).

Structure and governance. The program would be managed by the community health department with human resources, open by application, with ambassadors' supervisors agreeing to the protected hours. Two ambassadors would hold voting seats on the community health committee, and ambassadors would meet monthly as a group to share what they are hearing.

Measures. Number of ambassadors trained and retained; community events held and residents reached; concerns raised by ambassadors that led to a change in hospital services; turnover among ambassadors compared with other hourly staff; and residents connected to coverage or care through ambassador contacts.

How the Two Relationships Advance the Organization and the Community

The two relationships reinforce each other. Ambassadors who live in the housing developments can introduce neighbors to the health hub and bring residents' feedback back to the steering committee, while the hub gives ambassadors a place to refer the people they meet. Together, they address the drivers identified in Task 1 at more than one level: health literacy and economic security for individuals, and new organizational connections among the hospital, a public agency and the district's workforce.

For Millbrook, both relationships support its mission and its obligations as a nonprofit hospital to invest in community health. They also reduce costly, avoidable use of the emergency department and strengthen its workforce. For the community, they bring care and a voice closer to home.

Risks and Next Steps

The main risks are sustainability, if grant or community benefit funding ends; trust, if residents see the hub as surveillance by the landlord; and burden on ambassadors, if the role becomes unpaid extra work. Responses include building the hub's staffing into the hospital's operating budget after a two-year pilot, making clear that no health information is shared with housing management and that participation never affects tenancy, and protecting ambassadors' paid hours in writing. The next step is to present both proposals to the executive team and the housing authority's board, with a goal of opening the first hub and training the first ambassador group within nine months.

References

Gottlieb, L. M., Wing, H., & Adler, N. E. (2017). A systematic review of interventions on patients' social and economic needs. American Journal of Preventive Medicine, 53(5), 719-729. https://doi.org/10.1016/j.amepre.2017.05.011

Kangovi, S., Mitra, N., Norton, L., Harte, R., Zhao, X., Carter, T., Grande, D., & Long, J. A. (2018). Effect of community health worker support on clinical outcomes of low-income patients across primary care facilities: A randomized clinical trial. JAMA Internal Medicine, 178(12), 1635-1643. https://doi.org/10.1001/jamainternmed.2018.4630

Knopf, J. A., Finnie, R. K. C., Peng, Y., Hahn, R. A., Truman, B. I., Vernon-Smiley, M., Johnson, V. C., Johnson, R. L., Fielding, J. E., Muntaner, C., Hunt, P. C., Jones, C. P., & Fullilove, M. T. (2016). School-based health centers to advance health equity: A Community Guide systematic review. American Journal of Preventive Medicine, 51(1), 114-126. https://doi.org/10.1016/j.amepre.2016.01.009