Hennepin Healthcare Foundation

Report date
April 2018

What has been most instrumental to your progress?

Having engaged partners from multiple organizations, various backgrounds (health, housing, and services) and disciplines allowed for much greater breadth and depth of knowledge and contribution to both process and product. Unique perspectives helped to uncover opportunity and challenges and contributed to problem solving. Understanding local resources, history, and current landscape was vital, and each partner contributed and collaborated to paint those pictures.
Working with Wilder to develop, deploy, and analyze surveys not only engaged the group, but brought out key information to help move the project forward. Wilder completed two surveys, one with current and potential respite users, and one with referring agencies. The results were key in narrowing in on the target population we are hoping to serve, identifying the greatest needs (both physical and mental health), and pointing out challenges. The final report not only was instrumental in driving the model development, but also brought energy and focus to collaborative design and problem solving.
We were able to bring two nationally known subject matters to meet with our community stakeholder group, which supported our common understanding of both homeless medical respite as well as funding. The guests were 1) Dr. Jim O’Connell from Boston Health Care for the Homeless, who has been caring for individuals experiencing homelessness for over 30 years and was a driving force in getting Boston’s 100+ bed homeless medical respite up and running; and 2) Dr. Josh Bamberger, who has been in the field for many years in San Francisco, and has supported innovative blended payment models that leverage multisector funding sources to build and sustain programs that address both housing and health needs for medically fragile homeless adults.

Key lessons learned

Decision making by consensus with a large group can be challenging. Consensus may be key for some decisions, but determining which require consensus and which do not can certainly lend clarity and support momentum of the work.
Many health systems are newly engaged and energetic around addressing Social Determinants of Health, yet immature in developing an approach that complements or contributes to the work that those outside of health care are already doing and have been doing for much longer. There is an inherent challenge in harnessing that energy and providing focus for the health systems, while insuring that partnerships formed recognize the value each bring, and seek to be both creative and synergistic.

Reflections on the community innovation process

Inclusiveness and collaboration were both key. The work to develop the business plan required knowledge, expertise, and historical perspective from many different sectors. Additionally, to be able to move from planning to implementation will require strong partnerships across many agencies (even across different areas within agencies), willingness to contribute (time and resources) to a solution that truly requires community ownership to best support some of our most vulnerable community members. This project helped create and solidify partnerships that will help with the success of implementation.

Progress toward an innovation

With the grant, we were able to 1) Clearly identify a gap that exists in both shelter-housing and the health care continuum; 2) Identified target population, needs of that population and created a business plan that includes space design, size and services model; 3) Developed potential collaborative model that would exist at the intersection of shelter-housing and health care that would additionally leverage expertise and efficient use of resources from multiple sectors; 4) Created a pro-forma and identified funding opportunities; 5) Built understanding of the model amongst community partners, leaders, and policy makers; and 6) Increased the visibility of the problem, as well as the political goodwill to work toward creating a sustainable homeless medical respite model to address the gap and improve outcomes.

What it will take to reach an innovation?

Not applicble.

What's next?

The business plan developed with the support of the Bush Foundation Community Innovation grant has been transitioned to a working group at Hennepin County for further development and implementation. Additionally, the homeless medical respite model has become integrated into multiple key stakeholder conversations, seen a natural intersection in the continuum for both shelter-housing and health care, and has garnered support to continue pursuing the building of a robust program.

If you could do it all over again...

Although we developed a Steering Committee for the Task Force part way through the grant period, it may have been helpful to have had that from the beginning. The two reasons are: 1) As Hennepin County Medical Center (HCMC) was the facilitator of the Task Force, it was challenging (especially in the beginning) to really have this seen as a “community” initiative, and not as an HCMC initiative; and 2) Having a core group responsible for supporting the work of the larger group may have been beneficial in moving the work forward in a more timely fashion.

One last thought

Nothing else to share at this time.