EMBRACING AN ANCHOR MISSION The Root Cause Coalition 2018
Kate Sommerfeld, President, ProMedica
Dr. Ryan Bosch , Founder and President, Socially Determined
Valerie Moffitt, Senior Program Officer, Toledo- LISC
Michael Osborn, Chairman of the Board, Credit Adjustments
Kate Sommerfeld President, Social Determinants of Health
ProMedica
What’s our Mission?. . . • Short Statement of an Organizations Purpose, AIMS, Values, & Identifies Your Scope of
Operation
• An Expression, made by It’s Leaders, of Their Desires & Intent for the Organization
• Purpose is to Focus and Direct the Organization
• Your Theory of Change and Strategic Plan is the “How”
Why Do We Exist?
WHAT IS SUCCESS?
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• 332 sites
• 15 hospitals
• Six ambulatory surgery centers
• 2,350+ licensed inpatient beds
• 338 continuum service beds
• 334,000+ Paramount insurance members
• 900+ employed physicians and providers
• 2,300+ physicians with privileges
• 15,000+ employees
• 90,000+ inpatient discharges
• 71,000+ surgeries
• 8,200+ births
• 422,000+ rehabilitations therapy encounters
• $3.1 billion revenue
• Strong financial ratings
• Rated 99th out of 180 in Gallup Well-Being
Index
• 70% of adults overweight
• 36% of low-income families concerned about
having enough food
• Ranked 69th of 88 counties for health outcomes
• Large race disparity for infant mortality / low-
birth-weight babies
• Ranked 5th for concentrated, extreme poverty
in the country
• 28% of youth reported they felt sad or hopeless
every day for 2 weeks or more in a row
• 29% children living in poverty
• Highest number of homeless students in public
school system in the state
How do we make a distinct impact relative to our resources?
ARE WE ASKING THE RIGHT QUESTIONS?
We do … But we don’t … Ask about and encourage exercise Ask about safety in neighborhoods
Ask about and encourage people to
lose weight
Check vital signs
Ask about their diet and ability to
secure healthy food
Look for signs of toxic stress
Ask about their insurance information
Screen for mental health
Check a child’s growth
Physical examinations
Ask if they can’t readProvide education to patients
Ask if they have transportationCriticize patients who fail to show
up for appointments
TRANSFORMING CARE DELIVERY
• Screening across 10 SDOH
domains
• Wrap around supports
• Community health workers
• Food prescriptions
• Transportation assistance
• Housing prescriptions
• Food at discharge
• Closed-loop referrals
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WHAT ARE ANCHOR INSTITUTIONS?
HealthcareAnchor.Network
• Nonprofit or public
institutions
• Rooted in place-
“sticky capital”
• Economic engines-
large purchasers,
employers & investors
THE ANCHOR MISSION APPROACH
By leveraging our business practices around
inclusive, local hiring and workforce
development, local and diverse sourcing, and
place-based investing, we can tackle the
underlying causes of poor health by investing in the
social and economic well-being of the communities
we serve.
HealthcareAnchor.Network
DOWNTOWN TOLEDO REVITALIZATION
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22nd Century Plan• Advance a better connected downtown
• Establish downtown housing incentives
• Identify Strategic Redevelopment and infill sites (Uptown
Green and Four Corners)
• Conduct a parks master plan
• Conduct a Convention Center study
• Business/Economic Development Plan
• Complete the Riverfront Promenade
• Advance the Nautical Mile concept
• Acquire/activate the marina district site
• Establish an incubation and innovation center downtown
• Activate Summit Street
• Implement bike plan, starting with Jefferson Avenue Cycle Track
• Create a walkable city – need destinations to walk to
REVITALIZING TOLEDO
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NEIGHBORHOOD REVITALIZATION
UPTOWN NEIGHBORHOOD
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• 1900 Individuals
• 850 Households
• 260 families
• 83% live in apartment buildings
• 70% have annual income less than 25K
• 70% live in rental housing
• 36% ages 0-18
• 63% ages 18-65
• 15% work in healthcare/social support
• High patient costs
• Higher discharges
• Higher ED visits
• Higher Non-Admit ED Visits
• Double rate of babies born at low-birth
weight
• Higher readmission rates
• Higher asthma rates
PLACE BASED STRATEGY
PLACE MATTERS TO HEALTH
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EBEID CENTER
16
CREDIT ADJUSTMENTS, INC.
• Call-Center
• Commitment to hire from
neighborhood
• Second chance hiring
• 58 current jobs
• 500 future jobs
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DATA DRIVEN APPROACH
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Health
Housing• # of Affordable Units Created
• Home Value Trends
• # of Families Assisted
• # of Side Lot Transfers
• # of individuals under 30% of income
• # of pregnant moms with stable housing
• ER Use
• PMPM
• Readmit Rates
• Infant Mortality
• Access
• Improve health
outcomes
Jobs/Income • # Job Created
• Median Income
• % Participants
Settling Debt
• Taxes Refunded
• % Participants
Building Credit
Education • 3rd Grade Reading
• 3rd Grade Math
• Graduation Rate
• Kindergarten
Readiness
Safety• Homicides
• Safety
• Resident
Leadership
• Robberies
Valerie Moffitt Director of Financial Opportunities—Toledo
LISC
LISC’S ROLE AS A COMMUNITY DEVELOPMENT FINANCE INSTITUTION (CDFI)
Pool public and
private dollars
We raise funds from philanthropies, corporations and financial firms, federal, state and local governments and through the capital markets.
We also generate income from consulting, and lending services.
Work with local partners
Through a network of local offices and community-based partners across the country, we provide grants, loans, equity and technical assistance.
We also lead advocacy efforts on local, regional and national policy.
LISC is an
investor,
capacity
builder,
convener, and
innovator.
Support people and places
By investing in housing, businesses, jobs, schools, public spaces, safety, youth, health centers, grocery stores and more, we catalyze opportunities in communities nationwide.
PLACE-BASED COMPREHENSIVE COMMUNITY DEVELOPMENT:
AN APPROACH TO ADDRESSING SOCIAL DETERMINANTS
Significant racial disparity
in homeownership rates
Income inequality linked
to lack of access to
living wage jobs
Wealth Building Housing stability Reinvestment Economic Development
Targeted investment in these comprehensive community development priority areas, paired with supportive programmatic efforts improves social determinants.
Extreme housing instability among low-income persons
Largest rate of homeless in city concentrated in ENP target area
Extensive blight and vacancy plagues ENP target area
Strong need for access to financing and technical assistance by MWBEs
Make target neighborhoods and residential business districts vibrant
Ensure people at all
income levels have
stable housing
Increase
homeownership and
educational attainment
among people of color
Support MWBE’s access to economic opportunity in target area
FINANCIAL COACHING
• Regular 1:1 interaction
• Financial education
• Credit Counseling
• Access to innovative financial products designed to assist low income people build credit and avoid predatory lenders
• Homebuyer education & counseling
CAREER COACHING
• Accenture Career Success Skills Curriculum
• Support & accountability for clients as they explore and pursue career pathways
• Connections with local employers
• Connections to workforce training & education
INCOME SUPPORTS
• Tracks clients progress over a period of time
• Quantitative results
• Evidence-based best practice
• Continuous program improvement
SHARED DATA SYSTEM
EMBEDDED IN TRUSTED COMMUNITY ORGANIZATIONS | TRAINED, PROFESSIONAL COACHING STAFF | ISD MODEL
FINANCIAL COACHING
INCOME SUPPORTS
CAREER
COACHING
SHAREDDATA
SYSTEM
LISC FINANCIAL OPPORTUNITY CENTER (FOC) MODEL
• Ohio Benefits Bank Counseling
• SNAP
• Medical Benefits
• Rental Assistance
• Childcare
• Free Tax Prep
FOC THEORY OF CHANGE
Long-Term Employment
Increased Income
Improved Credit Scores
Gains in
Net Worth
Career Coaching
Career Coaching +
Income Supports
Career Coaching +
Income Supports +
Financial Coaching
Data Tracking
A job alone is not enough. By bundling
core services in the areas of financial
capability, career development and access
to public benefits individuals will achieve…
WHY FOCS? PROVEN RESULTS
FOC clients who take advantage of integrated services are :
• 50 percent more likely to land a well-paying job than people receiving employment
services alone.
• 2 times more likely to achieve long-term job retention—holding a job for a year or
more—when financial coaching reinforces the work of employment counseling.
View the full report: Building Sustainable Communities: Integrated Services and Improved Financial Outcomes for Low-Income Families (S. Rankin, LISC, April 2015)
http://www.lisc.org/media/filer_public/8d/d0/8dd0ddcd-e6b4-443a-bf47-a0c67096e212/041415_srankin_foc_report.pdf
Additionally, FOC clients who take advantage of integrated services are
more likely to:
• Reduce non-asset related debt
• Build positive credit histories
View the full report: First Steps on the Road to Financial Well Being: Final Report from the Evaluation of LISC’s Financial Opportunity Centers (A. Roder, Economic Mobility
Corp., Sept. 2016) http://economicmobilitycorp.org/uploads/16024%20First%20Steps_R5-REPORT-web.pdf
LISC—PROMEDICA INVESTMENT FUND
• $25 million ($15 Million LISC & $10 Million ProMedica)
• Loans ($30k-$6Million)-Predevelopment-Acquisition-Construction-Mini-Perm & Bridge-Bond Financing-Small Business
• Equity-Affordable Housing (NEF)-Economic Development (NMSC)
• Interest & Term-LISC Risk Rating from 4.5-7%-12 months-25 years
$45 million joint investment to address Social Determinants
• $20 million ($10 Million LISC & $10 Million ProMedica)
• Grants
-Support Programmatic Interventions
focused on improving education,
workforce, family stability and health
equity
-Resident Engagement
-Creative Placemaking
-Safety
-FOC
-Infant Mortality
-Homelessness Prevention & Rehousing
Loan Fund – Supporting Housing &
Economic Development Projects
Grants – Supporting Grants &
Programs
PLACE-BASED COMPREHENSIVE COMMUNITY DEVELOPMENT APPROACH
TO IMPROVING HEALTH
Investment: Housing
Development for
Homeownership
Wealth Building Housing Stability Reinvestment Economic Development
Investment: Affordable Multifamily Rental Housing Development
Investment: Commercial and Retail Development, Corridor and Public Space Improvements
Investment: Small Business Lending, Educational and Community Facilities
Thematic Priorities Investment Examples:
Programming: FOCs provide financial
planning, facilitate access to available
resources, benefits, and services, assess
obstacles to financial stability (child care
gaps, workforce development and
training needs, etc.); Housing Case
Manager ensure chronically homeless
individuals remain re-housed
Programming: Community building,
resident leadership identification and
skills building, and civic engagement to
improve social infrastructure, safety
initiatives create “eyes on the street” and
social contracts among neighbors and
businesses for long term collaboration
Programming: LISC Financial
Opportunity Centers and Bridges to
Career Opportunities to facilitate
financial capability, benefits access,
homeownership education, and
implement industry-contextualized
training programs
Programming: Capacity building of existing
and new businesses to be able to participate
in procurement opportunities, small business
network development and support, financial
planning and workforce development (job
readiness; technical training and education)
and initiatives to create and prepare labor
pool for sustained employment
Prevent/Mitigate
Multiple Chronic
Diseases and Cancer
Prevent/Mitigate violence
related injuries and
fatalities,
substance dependency
Prevent/Mitigate
Asthma and Respiratory
Disease
Improve Mental
Health and Wellness
Ryan Bosch MD
Founder and President
Socially Determined INC.
Addressing the Root Cause of
Healthcare Outcomes
We believe the future of improved health and wellbeing for
communities lies in leveraging integrated clinical, social, and
community contextual data to identify, prioritize, and
effectively address risk.
Socially Determined brings together an industry-leading,
multidisciplinary team of clinicians, public health experts, data
scientists, technologists, and management consultants all
converged around the singular goal of quantifying social
determinant risk to empower our clients to address these
risks through targeted, scalable, value-driven interventions.
Economic Wellbeing
Food Security
Housing
Transportation
Social Support
Health Literacy
Crime & Violence
AccessPreventive CareDisease Management
BiologyGenetics
Air QualityBuilt Environment
Social Determinants of
Health
Your Life – 50%
Your Healthcare – 25%
Your Biology – 15%
Your Environment – 10%
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SOCIALLY DETERMINED INC.
.
First purpose-built
social determinant
analytics platform.
Analytics-as-a-Service
with integration and
delivery service support.
Compelling Tech with
Services model drives
impact for vulnerable
populations.
$
WHY THIS MATTERS
.
+
HOUSING
INSECURITY
HEALTH
LITERACY
FOOD
INSECURITY
SOCIAL
SUPPORT
CRIME &
VIOLENCE
ECONOMIC
WELLBEING
TRANSPORTATION
BARRIERS50-70% of health care costs are SDOH
Payers and providers lack systems of
measurement, putting billions at risk
State-of-the-art is disparate social
programs and single issue initiatives
SDOH drive up cost of care
Fragmented approaches abound
No infrastructure to address
SOCIALSCAPETM ANALYTICS PLATFORM
ASSESSING RISK: SCREENING VS. ANALYTICS
= ProMedica patients screening positive for financial strain.
= ProMedica patients living in locations with high economic risk.
Positive Screens for Financial Strain Economic Risk
SOCIAL RISK AND CLINICAL COMPLEXITY
Economic Wellbeing Risk Clinical Complexity (4+ Chronic Conditions)
SOCIAL RISK AND SPECIFIC DISEASE
Food Insecurity Risk Diabetes
Michael Osborne
Chairman of Board
Credit Adjustments, Inc.
Q & A
