Impact Fellows Report on Completed Projects to Community Stakeholders

Becky RasmussenAlumni, News

2018-19 FOCUS Impact Fellows

Since August 2018 the FOCUS Impact Fellows have been digging into and creating impactful projects within the regional healthcare safety net seen through a racial equity lens. This is the second year the program has focused on the issue of healthcare, with the generous support of the Missouri Foundation for Health. In December 2018 the Fellows divided into three working groups and partnered with community organizations (St. Louis Integrated Health Network, Gateway Housing First, Behavioral Health Network of Greater St. Louis, BJC HealthCare, Affinia Healthcare, and St. Louis Community College, among others) to develop project ideas.

On May 10, 2019, the Impact Fellows reported out on their completed projects to community stakeholders, including health system CEOs, nonprofit provider directors, healthcare funders and more. Each project saw the working group of fellows addressing a problem identified by community partners.

Working with a variety of stakeholders, including Gateway Housing First, the “DWell” project identified a particularly pernicious gap in high-support housing services for the unhoused who suffer from behavioral or addiction issues. The project developed a case for funding high-support housing for these “familiar faces” from the Emergency Departments based on avoided costs for healthcare provided, as well as avoiding federal penalties for re-hospitalization and poor outcomes this population often exemplifies.

The “Churn to Earn” project addressed the difficulty of developing and retaining the medical assistants who are such a crucial part of the healthcare safety net workforce. Medical assistants support everything the nurses and physicians do, and often come directly from those vulnerable populations that the community health centers serve. Working with the St. Louis Integrated Health Network, St. Louis Community College, and Affinia Healthcare (among others), this project group created surveys and focus groups and developed a set of data and recommendations around retaining and developing a professional path for this crucial entry-level workforce. These recommendations will inform IHN’s current initiatives on healthcare workforce development and are aimed at the community healthcare centers who identified medical assistant retention as one of their top operational difficulties.

The “NeSTLed” project sought to develop equitable diversion programs for those St. Louisians who encounter law enforcement due to a behavioral or addiction crisis. Currently the only options for such individuals are to end up at the Emergency Department or jail. Neither are the right place for someone in such a crisis. Working with the Behavioral Health Network, this group researched best practices from around the nation and developed some core recommendations for a diversion program in St. Louis. The team also collaborated with area hospital systems to extract a data set from their ED admissions that will define the scope of the problem. To our knowledge this will be the first time such a specific data set existed in St. Louis.

The impact of these projects will only grow as the information and recommendations generated are taken up into the ongoing work being done by the community partners.

Next year, the Impact Fellows program will switch subjects to look at workforce development as it relates to decarceration. One of the most important factors determining the recidivism and probation and parole violation rates is a steady paying job. How do we simultaneously get more St. Louisians working, and reduce the number who are locked up? This area of work presents huge opportunities currently given the economy, the national attention on law enforcement and the costs it imposes on society, as well as the political alignment in the state on both workforce issues and decarceration. Applications are now being accepted for the 2019-20 cohort of FOCUS Impact Fellows and are due by May 31. If you have questions, please contact Program Director Dr. Wally Siewert at or (314) 657-4026.