Filed under Effective Practice, Economy / Housing & Homes, Adults, Women, Men, Older Adults, Racial/Ethnic Minorities

Goal: The objective of this article is to describe Project Restoration's approach to cross-sector collaboration with a shared population of high utilizing community members, describe the process and outcomes of the collaboration, provide strategies to mitigate challenges that arise during collaboration and offer insights to inform similar initiatives in communities nationwide.

Impact: Hospitals across the region are assessing ways to establish a centralized infrastructure to collaboratively address the complexities of individual cases, as well as a regional council to explore process improvements to enhance the lives of vulnerable populations.

Filed under Evidence-Based Practice, Health / Physical Activity

Goal: MANNA uses nutrition to improve health for people with serious illnesses who need nourishment to heal. By providing medically tailored meals and nutrition education, we empower people to improve their health and quality of life.

Impact: MANNA members report significant health care cost reductions due to improved health.

Filed under Effective Practice, Health / Children's Health, Teens, Adults, Families

Goal: The goal of FACE-ACP is to give adolescents and adults living with a serious medical condition a voice by facilitating conversations between patients and their caregivers so they can achieve their goals and match medical treatment to their goals.

Filed under Effective Practice, Environmental Health / Energy & Sustainability

Goal: The objectives of the program were:
-assist lowincome customers,
-reduce energy use at city facilities and
-coordinate action between the city and its largest electric customers to implement emergency demand reduction/ load-shedding programs.

Filed under Effective Practice, Environmental Health / Energy & Sustainability

Goal: The energy goals of the committee were to save money, reduce energy usage and to "stay on" during blackouts to avoid sending employees home.

Filed under Good Idea, Health / Cancer, Adults, Rural

Goal: To get as many age appropriate people screened as possible in the community and to raise awareness about the life-saving practice of colorectal screening.

Impact: Many cancers have been found and many have been prevented. The population has expressed gratitude for this program and the partners (such as the pharmacies and the hospital lab) are proud to be part of it.

Filed under Evidence-Based Practice, Economy / Housing & Homes, Adults, Racial/Ethnic Minorities

Goal: To evaluate the association of a “Housing First” intervention for chronically homeless individuals with severe alcohol problems with health care use and costs.

Impact: Total cost offsets for Housing First participants relative to controls averaged $2449 per person per month after accounting for housing program costs.

Filed under Good Idea, Health / Health Care Access & Quality, Children, Families

Goal: Healthy Kids plans to enroll all uninsured children who are not eligible for Medi-Cal and who are residents of Sonoma County in the health care and insurance program.

Filed under Effective Practice, Health / Cancer, Adults, Urban

Goal: The goal of this program is to increase access to colorectal cancer screening by improving the efficiency in health care clinics.

Filed under Evidence-Based Practice, Economy / Government Assistance, Older Adults

Goal: The goal of this program is to reduce costs by using specially trained community health workers to help connect people with unmet long-term needs and/or those at risk of entering nursing homes to Medicaid home and community-based services.

Impact: Similar interventions may help other localities achieve cost-saving and equitable access to publicly funded long-term care options other than institutional care.