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MARC HOLZER, SERIES EDITOR

Innovation in the Public and Nonprofit Sectors

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A PUBLIC SOLUTIONS HANDBOOK

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Edited by Patria de Lancer Julnes and

Ed Gibson

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Leadership Developing Partnerships to Address the Social Determinants

of Health

Richard F. Callahan

INTRODUCTION

The story of nonprofit innovatlons at the Sierra Health Foundation (SHF) over the past three years addresses access to health care and the social determinants of health. As a regionally focused foundation, Sierra Health Foundation's Chief Executive Officer, Chet Hewitt, and Board of Directors have developed structural and strategic innovations to expand the geographic reach and impact of the foundation. In the years from 2008 through 2014, the leadership of SHF, driven by an underlying belief in the research on the social determinants of health .. ,.,discussed and developed a range of public and non­profit partners, along with diversified funding to address a wide range of health access, equity, and outcomes issues. The leadership at SHF created a new structure to expand their service region, to attract additional public funding, and to develop new partnerships with other grant making organizations: The innovations in this case study offer insight into the Great Recession as a catalyst for change, as opposed to retrenchment, as well as new strategy driving new structures.

As the SHF celebrated its 25th anniversary in 2008, three significant forces were reshaping the foundation's future direction. One, the unfolding of the Great Recession of 2008 reduced the endowment's investments and returns. Two, a growing body of public health research described as the social determinants of health, finding that the neighbor­hood with wide variances of environment, economics, education, services and health access accounted for individual health outcomes more than clinical care. And three, an increasing recognition of the vulnerable safety-net of community clinics in health delivery system that was not seen as positioned to take advantage of significant changes in national health care policy promoting health equity and reduction of health dispari­ties. Chet Hewitt, as CEO of SHF, faced a limited geographical reach, the 26 northern, in-land counties in California, extending from the northern end of1the central California San Joaquin Valley, through the state capital city of Sacramento, to the Oregon border.

In response to these three forces, the leadership at SHF launched a set of inno­vative initiatives to attract health funding to the region (the timeline of events is

187

204 RICHARD F. CALLAHAN

'REFERENCES

Alvarado, G. (2013, December 16). Interview by author. Sacramento, CA. Barnes, W. (2014, January 8). Interview by author. Sacramento, CA. Collins, J. (2001 ). Good to great: Why some co111pa11ies make the leap and others do11 't. New York,

NY: HarpcrsCollins. ---. (2005). Good to great and the social sectors: A monograph to accompany good to great. New

York, NY: HarpersCollins. Collins, J. & Hansen, M. T. (2011 ). Great by choice. New York, NY: HarperCollins. Cels, S., De Jong, J, & Nauta, F. (2012). Agellts of clumge: Strategy and tactics for social i1111ovatio11.

Washington, D.C.: Brookings Institution Press. Crutchfield, L. R., & McLeod Gr.int, H. (2008). Forces for good: The six practices of high-impact

11011profits. San Francisco, CA: Jossey-Bass. Goldsmith, S., Georges, G., & Burke, T. G. (2010). The power of social i1111ovatio11. San Francisco, CA:

Jossey-Bass. Heinrich, C. J., Hill, C., & Lynn, L. E., Jr. (2004). Governance as an organizing theme for empirical

research. In: P.W. lngr.iham and L.E. Lynn Jr. (Eds.), The art of gorema11ce: A11alyzi11g mwiagemellt mid admi11istratio11 (pp. 3-19). Washington, D.C.: Georgetown University Press.

Hennocillo, J. (2014, January 24). Interview by author. Sacramento, CA. Hewitt, C. P. (2012, September 30). Can primary care safety net handle region's newly insured?.

Sacramento Bee, pp. E5. ---. (2013, December I I). Interview by author. Sacramento, CA. Johnson, G. (2014, May 28). Interview by author. Sacramento, CA. Kidder, 1: (2003). Mo1111tai11s beyo11d 1110w1tai11s: Heali11g the world: The quest of Dr. Paul Farmer.

New York, NY: Random House. Kotter, J.P. (1996). leading·tha11ge. Boston, MA: Harvard Business Review Press. Littlefield, D. (2014, January 7). Interview by author. Sacramento, CA. Milward, H. B., & Provan, K. (2006). A manager's guide to choosing and using collaborative networks.

(IBM Center for the Business of Government Report) Retrieved from www.businessofgovemmcnl. org/rcport/managers-guidc-choosing-and-using-collaborative-networks

Moore, M. (1995). Creating p11blic·value. Cambridge, MA: Harvard University Press. Ospina, S., & Foldy, E. (2010). Building bridges from the margins. The Leadership Quarterly, 2 /(2),

292-304.Parks, Y. (2009). Children ar1dfamily first. Casey Family Programs. Prevention Institute. (2013 ). Sacmme11to Cow1ty communit)' health policy scan. ( Sierra Health Foundation

Report). Salamon, L. M. (2012). The resiliellt sector: The future of no11pro.fit America. Washington, D.C.:

Brookings Institution Press. Sierra Health Foundation. (2012). 20/1-2012 report partnerships: The power to clia11ge. (Sierra

Health Foundation Report). ---. (2010). Partnerships with a purpose: Reac/1i11g 011rlcreating change. (Sierra Health Foundation

Report). Yin, R. K. (2014). Case study research: Design a11d methods (5th ed.). Thousand Oaks, CA: SAGE.

Innovation in the Public and Nonprofit Sectors A PUBLIC SOLUTIONS HANDBOOK

"De Lancer Julnes and Gibson have assembled a collection that provides a much needed antidote lo the view that It is only the private sector that innovates. From municipal planning and technological innovations, through coaching in community colleges and measuring culture value in museums, to collaborative governance arrangements, this collection showcases the wealth of innovation occurring in the public and not-for-profit sectors. It is a must read for anyone interested in this topic." Jenny M Lewis, University of Melbourne, Australia

"Public managers are expected to be innovative and "do more with less," but actual innovation cannot be reduced to a checklist. Innovation in the Public and Nonprofit Sectors is rich in current, practical demonstratrons that inspire and provide lessons in how to be innovative. It is ideal as a text for professionals in training as well as practitioners." Alan Lyles, University of Baltimore, USA

"An excellent compendium of cases from the nonprofit and public sectors that moves us well beyond traditional approaches to innovation. These cases and their analyses point us toward the next generation of research and practice and afford us a much more nuanced understanding of innovation in all of its complexity." Nancy Roberts, Naval Postgraduate Schoof, USA

In the organizational context, the word "innovation" is often associated with private sector organizations, frequently perceived as more agile, adaptable, and able to withstand change than government agenties and nonprofit organizations. Through a diverse collection of international case studies, this book broadens the discussion of innovation to include public and nonprofit organizations, demonstrating the hurdles these organizations face, and examining the technological advance� and managerial ingenuity innovators use to achreve their goals within and beyond the boundaries of the innovating organization. The chapters shed light on key issues including:

• how to conceptualize innovation;• how organizations decide between competing good ideas;• how to implement innovation; • how to contend with challenges to innovation;• how to judge success in innovation.

•,

This book provides current and future Jfublic managers with the understanding and skHls required to manage change and innovation, and is essential reading for all those studying public management, public administration, and public policy.

About the Editors .

Patria de Lancer Julnes, PhD, is Professor and Director of the Doctor of Public Administration Program in the School of Public Affairs at Pennsylvania State Universi�y, USA.

Ed Gibson, PhD, is Associate Professor of Public Administration in the College of Public Affairs at the University of Baltimore, USA.

MARC HOLZER, SERIES EDITOR

Each volume in the Public Solutions Handbook series supplies cor11prehensive, current, theory-to-practice information on a specific field and is an,essential resource for anyone seeking to master that field. Series Editor Marc Holzer is Dean of the School of Public Affairs and Administration, and Board of Governors Professor of Public Affairs and Administration at Rutgers University's Newark Campus, as well as a fellow of the National Academy of Public Administration ancl the World Academy-of Productivity Science.

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Innovations in the public and nonprofit sectors : a public solutions handbook I edited by Patria de Lancili' J ulnes and Ed Gibson.

pages cm.-(The public solutions ha�dbook series) Includes bibliogr.iphical references and index.

1. Organizational change. 2. Public administrnlion-Technologicalinnovations. 3. Administrative agencies-M1111agcment. 4. Administrative agencies-Effect of technological innovations on. 5. Nonprofit organizations-Management. 6. Nonprofit organizations-Effect of technological innovations on. Julnes, Patria de Lancer, editor of compilation. I Gibson, Ed, editor of compilation. JF1525.073 1577 2015 658.4/063-dc23 2015020168

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