MHA 560 Week 6 Fostering Healthy Communities: A Sustainable Legacy Plan Example

Hiring, Buying and Investing on the North Side: An Anchor Mission That Ties a Hospital's Legacy to the Health of Its Neighborhood

[Student Name]

University of Phoenix

MHA/560: Creating a Sustainable Legacy: Healthy Communities

Week 6 Assignment

[Instructor Name]

[Date]

The hospital, its neighborhood, programs, targets and results are composites written for a model paper; research findings come from the sources cited.

At a community meeting in a church hall near the composite Milwaukee safety-net hospital, a resident asked the chief executive a direct question: you are the biggest employer on the north side, so why do so few of us work there except in housekeeping? The chief executive, in her last year before retirement, had no good answer. This paper presents the answer she built: an anchor mission tying the hospital's legacy to the health of its neighborhood.

The Question Behind the Question

The resident was asking what the hospital gave its neighborhood besides care. Earlier work had defined social sustainability as strengthening the community's health and resilience. The anchor mission puts that definition into operation.

What an Anchor Mission Is

Hospitals and universities are called anchor institutions because they are rooted in their places and unlikely to leave. An anchor mission commits such an institution to use its economic power, through hiring, purchasing and investment, to benefit its community. A national review of hospitals and health systems with declared anchor missions, drawing on literature, public documents and interviews with key informants, identified potential best practices for adopting, operationalizing and implementing an anchor mission and noted early outcomes, while observing that research on its effect on community health was still limited (Koh et al., 2020).

The Neighborhood's Needs

The community health needs assessment and listening sessions described a neighborhood with high unemployment, housing instability, few local businesses and high rates of asthma, diabetes and premature death. Residents' top priorities were jobs, safe housing and respect.

Strategy One: Hire Locally

The hospital employs about 2,200 people, but only 9% lived in the surrounding zip codes, mostly in entry-level roles. The plan creates a training pipeline with a local community college for medical assistants, pharmacy technicians, surgical technicians and patient care technicians, with paid training, tutoring and guaranteed interviews. Residents of the surrounding zip codes receive priority. The target is 20% of new hires from those zip codes within three years, with a career ladder into nursing.

Strategy Two: Buy Locally

The hospital spends about $140 million a year on goods and services. The plan directs supply chain to identify categories, such as food, printing, landscaping and facilities services, that local and minority-owned businesses can supply, and to help small businesses meet requirements through a supplier development program. The target is to shift $8 million a year to local businesses within three years.

Strategy Three: Invest Locally

The hospital will place $5 million of its long-term investment reserves in community development financial institutions that fund affordable housing and small businesses on the north side.

Evidence on Social Needs Investments

Health systems are increasingly making such investments. An analysis of health system investments in social determinants of health from 2017 to 2019 identified 78 programs by 57 health systems, together including 917 hospitals, totaling no less than $2.5 billion, with housing alone drawing about $1.6 billion, with other programs in employment, education, food security and transportation (Horwitz et al., 2020). Housing drew the most money because a patient without a stable home cannot follow a care plan.

Strategy Four: Community Health Workers

The hospital will expand its community health workers, hired from the neighborhood, who help patients with appointments, medicines and social needs. Economists using data from a randomized trial of one standardized program put its payback at $2.47 per program dollar for a typical Medicaid budget within a single fiscal year (Kangovi et al., 2020). With about 60% of its patients on Medicaid or uninsured, the hospital will seek Medicaid managed care contracts to fund the program.

Why Hiring Comes First

Of the three economic levers, hiring affects residents most directly. A stable job with benefits affects income, insurance, housing and stress, all of which shape health. It also answers the resident's question in the most visible way. Purchasing and investment matter, but a neighbor in scrubs at the hospital entrance is the clearest sign that the hospital belongs to the neighborhood.

Removing Barriers to Employment

The human resources team reviewed hiring practices and found barriers: online applications that required email accounts many residents lacked, background check rules broader than the law required and interviews scheduled only during working hours. The hospital opened a hiring office in a neighborhood community center, narrowed background checks to what the roles required and offered evening interviews.

Learning From Other Anchors

The chief executive and council members visited two health systems with established anchor missions in other Midwestern cities. Both advised starting with a few measurable commitments rather than many, reporting results publicly and giving residents real authority. Both also warned that purchasing shifts take longer than expected because contracts renew on fixed cycles.

Sharing Decisions With Residents

A community council of twelve residents, including the woman who asked the question, meets quarterly with hospital leaders, reviews progress on every target and advises on priorities. Council members are paid for their time. The council has a seat on the hospital's community benefit committee.

Connecting the Three Levels

The plan connects the course's three levels of sustainability. Personally, it is the chief executive's legacy. Organizationally, local hiring strengthens the workforce pipeline and local purchasing supports resilience. For the community, jobs, housing and health support are what residents asked for.

Resources

The pipeline costs about $1.2 million a year, partly funded by workforce grants. The supplier program costs about $250,000 a year. Community health worker expansion costs about $900,000, with Medicaid contracts expected to cover much of it. The investment uses reserves rather than operating funds.

Measures and Targets

Measures include the share of new hires and total staff from surrounding zip codes, pipeline completion and retention, local spending, community investment deployed, community health worker reach and health measures such as avoidable emergency visits and asthma admissions among neighborhood residents. Results are reported publicly each year.

Risks

Pipeline graduates may not stay if jobs lack advancement; the career ladder addresses this. Local suppliers may struggle with volume; the supplier program provides support. Community trust can be lost if targets are missed; the council's oversight keeps the hospital accountable.

Early Signs

In the first six months, the pipeline enrolled its first cohort of 24 neighborhood residents, the neighborhood hiring office received more than 300 applications and supply chain moved its landscaping and printing contracts to two north side businesses. The community council's first report praised the hiring office and criticized the slow pace of purchasing changes, which the hospital accepted as fair.

Handing It On

The plan is written into the hospital's strategic plan, the council's charter and the next chief executive's objectives. The chief executive will introduce her successor to council members and partners before she leaves.

Conclusion

A resident's question about jobs became an anchor mission. Hiring, buying and investing locally, supported by research on anchor institutions, health system social needs investments and community health worker returns, and governed with residents, tie the hospital's sustainability to its neighborhood's health. The legacy is not the chief executive's name on a building but a hospital that works for its community after she leaves.

References

Horwitz, L. I., Chang, C., Arcilla, H. N., & Knickman, J. R. (2020). Quantifying health systems' investment in social determinants of health, by sector, 2017-19. Health Affairs, 39(2), 192-198. https://doi.org/10.1377/hlthaff.2019.01246

Kangovi, S., Mitra, N., Grande, D., Long, J. A., & Asch, D. A. (2020). Evidence-based community health worker program addresses unmet social needs and generates positive return on investment. Health Affairs, 39(2), 207-213. https://doi.org/10.1377/hlthaff.2019.00981

Koh, H. K., Bantham, A., Geller, A. C., Rukavina, M. A., Emmons, K. M., Yatsko, P., & Restuccia, R. (2020). Anchor institutions: Best practices to address social needs and social determinants of health. American Journal of Public Health, 110(3), 309-316. https://doi.org/10.2105/AJPH.2019.305472