Leveraging Funds: A Model for Public-Private Collaboration

As a non-governmental agency that does not provide direct services, LPHI plays a unique role in helping develop a robust and sustainable primary and behavioral healthcare safety net in the post-disaster setting of greater New Orleans. LPHI’s private non-profit structure complements the role of government and enhances effectiveness by leveraging private funding to help stabilize, expand and improve community-based healthcare services for everyone, without regard for their ability to pay.

When the federal government awarded the $100 million Primary Care Access and Stabilization Grant (PCASG) to the Louisiana Department of Health and Hospitals in July 2007, the state chose LPHI to administer the grant as its local partner. In response, LPHI worked with state and federal government agencies to develop an implementation plan designed to optimize PCASG’s goals to increase access to care and improve quality of care. Because the federal funds came with strict limits on non-direct service-related expenditures, LPHI raised additional funds to maximize the impact of federal service delivery dollars. The following are examples of achievements to this end:

• With a technical assistance grant from the Commonwealth Fund in New York City, LPHI convened panels of nationally recognized experts for advice in designing PCASG’s payment methodology, quality improvement program and impact evaluation. Subsequently, the Commonwealth Fund dedicated nearly $1 million to study the impact of the federal grant on patient experience, clinic operations and regional healthcare utilization and cost.
•  With greatly exacerbated mental health problems in post-Katrina New Orleans, the need to expand access to behavioral healthcare was acute. Based on evidence that offering behavioral health services in the primary care setting is an effective strategy, LPHI secured a $838,544 Robert Wood Johnson Foundation grant to establish a technical assistance collaborative for healthcare organizations participating in the PCASG grant—it is called the Collaborative to Improve Behavioral Health Access (CIBHA).
•  A fully implemented electronic medical records (EMR) system is an essential component of the strategy to create a high performing primary care delivery system; however, spending PCASG funds on health information technology is prohibited. Thanks to private support from the W.K. Kellogg and Robert Wood Johnson Foundations, great advances have been made by LPHI and its partners in implementing EMRs in school-based health centers.
•  In order for people to get the primary and preventive care they need, they must be aware of the options available to them, know they can trust the healthcare providers and understand the value of establishing a source of ongoing primary care. With a grant from Baptist Community Ministries, LPHI is developing a Primary Care Outreach Campaign that will include paid and earned media tactics, community outreach, a staffed telephone hotline and an interactive website to help with these challenges.

The public and private nonprofit outpatient primary and behavioral healthcare providers participating in PCASG would not have been able to achieve significant results in improving access and quality care for Greater New Orleans residents without funding assistance from PCASG and the leveraged contributions of private philanthropy:

• Six-month patient volume has increased 15% on average for every six-month period since the grant began
•  20 service locations have been added
•  37 clinics have been recognized for quality by the National Committee on Quality Assurance (NCQA)

Continuing momentum and sustaining gains have now become principal challenges—challenges that will continue to require the dedication and focus of all stakeholders to address collectively as we move into the next phase of the PCASG initiative.