Hennepin Healthcare Foundation CI Report – Final

What has been most instrumenta 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.

Interpersonal and inter-agency politics are challenging, and while not always obvious or visible to everyone in the group, can certainly impact how the group functions and what progress can be made. While not leading to failure, definitely hindered the amount of progress made and speed which it was made, and led to several points where group stalled when otherwise would have been moving forward.

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.

Other key elements of Community Innovation

Resiliency, a part of building capacity, was instrumental in completing the work. There were times when external political landscape directly impacted both planned resources to build and sustain, and energy toward allowing for different uses of resources in a resource scarce environment that is now under additional threat.

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.