Image
Second Cohort of Delta Center Grantees Demonstrated Tangible Progress on Policy and Practice Improvements
Key Evaluation Findings
Launched in 2018, the Delta Center for a Thriving Safety Net is an initiative funded by the Robert Wood Johnson Foundation (RWJF) and led by JSI Research & Training Institute, Inc. (JSI). Strategic partners included the National Association of Community Health Centers, National Council for Mental Wellbeing, and Center for Accelerating Care Transformation at Kaiser Permanente Washington Health Research Institute. The ultimate aim of the Delta Center is to cultivate health policy and a care system that are both more equitable and better meet the needs of individuals and families.
Recognizing the vital role played by state and national associations in supporting community health centers and community behavioral health organizations, the Delta Center funded state primary care associations (PCAs) and behavioral health state associations (BHSAs) to foster cooperation and collective action among these entities in a State Learning and Action Collaborative. In its second phase (2021–2024), the Delta Center awarded grants to teams of PCAs and BHSAs from seven states: Alaska, Kansas, Louisiana, Mississippi, New Hampshire, Oklahoma, and Pennsylvania.
The Phase 2 Evaluation Report summarizes the progress state associations have made toward advancing policy and practice change during their participation in the Delta Center. The findings are based on qualitative and quantitative data collected through interviews and baseline, midpoint, and endpoint surveys with the 14 associations who participated in Phase 2.
Key Findings
State associations succeeded in advancing policy and practice issues related to their Delta Center goals: Top policy priorities for state associations included addressing the workforce crisis, expanding certified community behavioral health clinics (CCBHCs), and building on telehealth policies enacted during the COVID-19 pandemic. Many PCAs and BHSAs achieved policy successes and progress in these areas, often in collaboration with each other. In the area of practice change, grantees reported increased PCA-BHSA collaboration on provider member training and technical assistance related to integrated primary care and behavioral health, as well as equitable service delivery.
The Kansas team collaborated to advance integrated care through CCBHCs, working towards the transition of all of the state's Licensed Community Mental Health Centers into CCBHCs.
State associations strengthened partnerships, resulting in improved collaboration and collective action: PCAs and BHSAs substantially strengthened their relationship with each other, as demonstrated through increases in the level of mutual trust, greater communication frequency, and joint policy efforts and public presentations. They also increased their collaboration with other key groups, such as state legislators, state Medicaid agencies, public health departments, and Medicaid managed care plans. PCAs and BHSAs widely regarded the improvements in partnership and collaboration as the most valuable outcome of their participation in the Delta Center. Increased collaboration has provided a strong foundation for future collective action on policy and practice change.
Hear from Phase 2 grantees in our latest video series,
Transforming Care Through Collaboration: The Delta Center Story.
Associations enhanced engagement and incorporation of consumer voice: Despite challenges, PCAs and BHSAs increased their efforts to engage consumers. They partnered with state-level consumer advocacy groups, sought input from their members’ boards, and shared consumer perspectives with their members. At endpoint, 13 of the 14 PCAs and BHSAs reported that consumers informed different aspects of their work, compared to just a few at baseline.
State associations increased their understanding of and efforts to address health equity and racial justice: Associations grew in their understanding and efforts to address health equity and racial justice. More associations engaged in these efforts within their organization, with their membership, and through state policy.
Associations plan to build on their Delta Center projects: At endpoint, 4 of 7 state teams were actively exploring funding opportunities with federal or state agencies and foundations to support their ongoing efforts. Many PCAs and BHSAs were also actively taking steps to operationalize their partnerships through regular communication, shared policy development, and partnership at the board and member level.
Conclusion
The Delta Center’s second grantee cohort demonstrated tangible progress on policy and practice improvements through systems change efforts, improved collaboration and collective action, and growth in their approach to both consumer engagement and racial equity.
To sustain this progress, state associations should continue building strategic partnerships, elevate consumer voices, and prioritize equity in both operations and advocacy. For funders, supporting these efforts through flexible, multi-year investments will be essential to strengthening integrated, equitable healthcare systems that can adapt to changing political and social landscapes.
Read more in the full Phase 2 Final Evaluation Report.
Note: Funding stipulations from the Robert Wood Johnson Foundation prohibited the use of Delta Center funds for engaging in direct or grassroots lobbying.