Promoting Social Determinants of Health

On May 1, Brookings Institution gathered leaders in the field to discuss how to braid and blend funds to promote social determinants of health. Braiding coordinates two or more funding streams but each funding stream connects back to the original source so there aren’t any constraints on the funds.  Blending refers to the pooling of two or more funding sources into one funding stream.

Stuart Butler, Senor Fellow for Economic Studies at Brookings addressed the need to collaborate across sectors to deal with policy and other issues related to promoting social determinants. He stressed the importance to find more effective ways to help people when funds become available from different sources and programs.

To carry the conversation further on braiding and blending, the National Governors Association’s (NGA) Program Director Sandra Wiliness PhD reports,

“NGA is working with states on a number of issues pertaining to behavioral health and primary care integration. These issues include data exchange along with delivery system and payment reforms to incentivize best practices and how best to modify state Medicaid programs.”

NGA has worked with ten states and one territory to provide technical assistance to develop workable solutions to address the needs of complex care populations. Examining social-emotional issues, helping children to deal with adverse childhood experiences, and finding ways to reach disconnected youths are some of the issues that need to be addressed.

To point out how specific organizations are dealing with social determinants, Ana Novais, Deputy Director at the Rhode Island Department of Health reports, “The Department of Health is working with both Federal, state, and county agencies so people will not be treated in silos.”

She explained, “The State of Rhode Island’s “Health Equity Zones” program utilizes braided funding so that everyone has the right to a fair and just opportunity to be healthier. This requires removing obstacles to providing good healthcare for individuals in the community, dealing with the lack of access to good jobs, improving access to good transportation, and providing quality education along with safe housing in a safe environment.”

Patricia Valentine, Deputy Director for Integrated Program Services, for the Alleghany County Department of Human Services (DHS) in Pennsylvania, highlighted how child welfare has a number of cases where parents addicted to drugs will not go for treatment which very often puts the families and children at risk in the welfare system.

Recently, the new report “Allegheny County Predictive Risk Modeling Tool Implementation: Process Evaluation”  was published to enable the DHS to use predictive risk modeling to enable child welfare staff to decide which General Protective Services” referrals to investigate and which referrals to screen out.

Also, the Allegheny Family Screening Tool (AFST) has been developed to analyze data from the DHS data warehouse and the child welfare case management system to identify factors that are predictive of a child’s re-referral to child welfare or if the child should be placed into foster care.

DHS with support from provider agencies, information technology experts, legal counsel, and program staff developed “Client View” to improve access to data from the county’s data warehouse. This application enables client-level information to be available to service providers with contracts with DHS.

The Executive Director for the Anne Arundel County Partnership for Children, Youth, and Families in Maryland, Pamela Brown reports, “Although Anne Arundel County is considered wealthy, there are still pockets of poverty especially in Baltimore County. The goal is to have community agencies work together to share an agenda to reduce poverty and deal with the social determinants of health.”

She discussed a successful “Communities of Hope” program underway in Brooklyn Park, Maryland. This program is a coalition of residents, government, nonprofit agencies, business leaders, and philanthropists working to provide a stable home environment with economic opportunities for all, provide access to quality healthcare and education, provide mental health treatments, plus recreational and cultural opportunities for youth, along with after school care, and other social services.

She expressed the need for flexible budgets and since financing comes from several funding streams such as federal, state, and local funds, reporting and administering the funds requires a totally clean audit.

The panelists agree that braiding and blending funding has to meet the challenges related to financially managing the issues but also there is the need to invest time and money into data sharing. The whole issue requires the need to develop the correct policy steps and produce the right environment to support the braiding and blending of funds from the Federal government, States, and local communities.

Go to to view the video with comments by all of the panelists and moderators by clicking on Past Events.

Share Button