This document discusses leveraging cross-agency partnerships and funding streams to address social determinants of health and improve population health. It provides the example of Louisiana's Permanent Supportive Housing program which braids funding from Housing and Urban Development, Medicaid, Ryan White, SAMHSA and the VA to provide both housing and services. It also discusses Virginia's Children's Services Act which pools funding from education, juvenile justice and social services. The document notes some benefits of cross-sector programs include resilience, efficiency and alignment, but also challenges around governance and complexity. It concludes with contact information for Amy Clary at the National Academy for State Health Policy.

1. 1
Amy Clary, PhD
National Academy for State Health Policy (NASHP)
Leveraging State Cross-Agency
Partnerships to Improve Population Health
Practical Playbook Annual Meeting
June 1, 2017; Washington, D.C.
www.nashp.org

2. State Levers to Address Two Trends
Trends:
 Addressing social determinants to improve health
 Tightening budgets
Levers:
 Cross-agency collaboration
 Braiding funding
2National Academy for State Health Policy www.nashp.org

3. 3
3
Meet Jean
http://www.nashp.org/braiding-and-blending-funding-streams-to-meet-the-health-related-social-needs-of-low-income-
persons-considerations-for-state-health-policymakers/
Image: NASHP

4. 4
States steward multiple funding sources
4
Image: NASHP
www.nashp.org http://www.nashp.org/braiding-and-blending-funding-streams-to-meet-the-health-related-
social-needs-of-low-income-persons-considerations-for-state-health-policymakers/

5. State Example: Louisiana Permanent Supportive Housing
5
http://nashp.org/braiding-funds-to-house-complex-medicaid-beneficiaries-key-policy-lessons-from-louisiana
http://www.dhh.louisiana.gov/index.cfm/page/1732

6. 6
Community
Development Block
Grant disaster
recovery funds
The program
formerly known as
Shelter + Care
Section 811
Project Rental
Assistance
Project-based and tenant-
based vouchers under the
Housing Choice Voucher
program
Funding for Louisiana PSH: Rental Assistance

7. 7
Funding for Louisiana PSH: Services
7
What it is What it pays for Source
Medicaid 1915(c)
Home and
Community-Based
Services Waivers
Long-term services and supports, including
tenancy supports
CMS
Medicaid State Plan Mental health rehabilitation services,
tenancy supports, habilitation services
previously covered under a 1915(i) waiver
CMS
Ryan White Security deposits, utilities, medical care,
health education, legal support, nutrition
support, and other services
HRSA
Cooperative
Agreement to Benefit
Homeless Individuals
Housing support, treatment for substance
abuse and/or serious mental illness, peer
support, and other services.
SAMHSA
Veterans Services Health care for eligible veterans US VA
National Academy for State Health Policy www.nashp.org

8. 8
Potential
Tenants Are
Referred to
Louisiana’s
PSH
Through
Various
Channels
Louisiana Dept. of Health
PSH Office

9. State Example: Virginia Children’s Services Act
9http://www.csa.virginia.gov/
http://www.nashp.org/pooling-and-braiding-funds-for-health-related-social-needs-lessons-from-
virginias-childrens-services-act/

10. 10
Virginia
Children’s
Services Act
Image: NASHP

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Image: NASHP

12. 12
Some Benefits Some Challenges
 Resilience
 Efficiency
 Alignment
 Whose pocket?
 Complexity
 Competing priorities
12
Benefits and Challenges of Cross-Sector Programs
National Academy for State Health Policy www.nashp.org

13. Contact Information
Amy Clary, PhD
Policy Associate
National Academy for State Health Policy
10 Free St, Portland, ME 04101
207/822-3918
aclary@nashp.org
http://nashp.org/30th-annual-state-health-policy-conference/