Return on Community Investment (ROCI):
A High Impact Institute

Pre-Conference Data Collection
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Return on Community Investment Survey Responses

Respondent Name:

Paula Lucey

E-Mail Address:

plucey@milwcnty.com

Organization Name:

Milwaukee County Health and Human Services

Phone:

(414) 257-5949   Ext.

Fax:

-

Address:

9501 Watertown Plank    

City, State, Zip:

Milwaukee , WI    53226
Category: Your Community

What is the service area of your initiative (counties, city, etc.)?

Milwaukee County

What is the total population in your service area?

900,000

What percentage of the total population lives below the federal poverty level?

Unknown

What percentage of the total population is uninsured?

10%
Category: Your Program Initiative

Indicate which of the following categories your initiative falls in:

Outreach and navigation
Common registration and enrollment
Primary care capacity and access
Emergency room usage reduction

Describe the purpose of your initiative (in one sentence, if possible):

A compressive network of health care access for knowledgeable clients at the community setting of their choice.

Describe the scale of your initiative in terms of budget, capacity, etc.:

The overall program has an annual budget of 38.4 million for the care of approximately 25,000 clients. Our CAP grant was for a total of 2.0 million.

Describe the operational components of your initiative:

Clients are screened for eligibility, select a primary care clinic, and our program will pay for put-patient, in-patient and emergency services. We will pay for specialty care as well as home care and Pharmacy services.

Describe your initiative's staffing level:

The overall program functions at a very lean 6% administrative cost. The CAP program was assumed in the overall program's activities. We purchase evaluation and research support from a local medical college.

If applicable, please describe your strategic use of an information system:

Information services have been very important to us. We have a web-based eligibility system which allows the diverse network of providers to know the status of clients at all times. We are consistently improving this system.

Please list the major, time-framed, measurable objectives your initiative is designed to achieve:

Our CAP grant was designed to support the overall General Assistance Medical Program in ways: Increasing the ability of the program to utilize electronic data, increasing the capacity of the network in the areas of clinical and business capacity, and patient education related to navigation in the program and self care.
Category: Measurable Results

Which of the following results can be attributed to your program initiative? Please check all that apply.

Coordinated System of Care Savings
Reduction of ER usage for non-urgent care
Savings from operational improvements within integrated system
Economic development factor
Social justice implications

Please list any other actual, measurable results of your initiative:

No response.
Category: Your ROCI Strategy

How do you define ROCI?

We worked with a consultant to complete a ROI study utilizing four components of return. We did this for our overall program.

Describe your ROCI objectives and strategy:

This was intended to help maintain the political will to keep the program in place during a time of great political change and turnover.

Describe the players involved in the ROCI conversation (by title and/or function):

Paula Lucey, Director, Milwaukee County Health and Human Services Joseph Cooper, now of Little Rock Ark, then Associate Director of Milwaukee County Health and Human Services

List the milestones in your ROCI strategy that pertain to deal making (a prospective approach):

No response.

List the milestones in your ROCI strategy that are tied to outcomes (a retrospective approach):

No response.

List the milestones in your ROCI strategy that are linked to sustainability:

The General Assistance Medical Program is a voluntary program. The strongest indicator of success is the ability to keep the funding in place.
Category: Your ROCI Methodology

Describe the analytic or economic logic underlying your ROCI method:

We utilized the approach described by Dave Rogoff of looking at four areas of direct and indirect returns.

Is your method supported by scientific research? If yes, please describe:

Mr. Rogoff has utilized this method in other places

Describe the measures that you used to define "returns" or value:

Financial

Describe the measures that you used to define investments or costs:

We utilized a four part method for looking at the Return on Investment in our community: Quality of Life, Direct Benefits, Indirect Benefits and Leveraged Funds. This allowed us to look at the program in a comprehensive manner. As part of our CAP grant, we were able to get Dave Rogoff to provide technical assistance in the process. Our bottom line showed that in 2000, for each dollar invested, we were able to return almost an additional dollar to the community. While we have not recalculated, since that time we have leveraged additional federal funds and grant monies so the amount has improved.

Please briefly describe your data collection methods.

No response.
Category: ROCI Communication and Negotiation

Describe the conversations that define your ROCI process:

We used our ROI report to share data with a newly elected county executive and county board of supervisors. This has helped us to maintain the political will to keep a VOLUNTARY program funded during times of extreme budget challenges. It has also helped us to change the framework of thought around the program to an ''investment'' rather than a donation. The ROI report also served as an evaluation tool and served as a spring board for planning efforts.

Describe how ROCI conversations are tailored to specific audiences:

Different groups needed more or less background on the program and the methodology.

Describe what enabled effective conversations to occur:

Leadership and existing relationships
Category: Results from the ROCI Process

Describe the outcomes, the successes of your ROCI strategy:

Ability to fund a voluntary program during a time of extreme budget constraint so that the program can continue to provide service to clients.
Category: Lessons

What do you see as the critical success factors that can guide others?

Outside help to assist in taking a step back away for your own program.

Do you believe that your results can be replicated successfully with other similar initiatives? Can you suggest how replication may be facilitated?

Yes, we have already been in discussions with many other communities regarding our program and it's results.