Hughes Dora L, Mann Cindy
Dora L. Hughes ( dhughes@gwu. edu ) is an associate research professor in the Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, in Washington, D.C.
Cindy Mann is a partner at Manatt Health, Manatt, Phelps & Phillips, LLP, in Washington, D.C.
Health Aff (Millwood). 2020 Apr;39(4):670-678. doi: 10.1377/hlthaff.2019.01581.
Accountable Communities for Health (ACHs) are collaborative partnerships spanning health, public health, and social services that seek to improve the health of individuals and communities by addressing social determinants of health such as housing, food security, employment, and transportation. ACHs require funding not only for programs and services but also for core infrastructure functions. We conducted a legal and policy review to identify potential funding streams specifically for ACH infrastructure activities. We found multiple and credible options at the federal and state levels and in the public health, health insurance, and philanthropic and private sectors. Such options could support ACH infrastructure directly or through reimbursement for administrative costs associated with programmatic work. Yet we also found that there is no dedicated or explicit source of funding for these critical functions. For sustainable and long-term ACH support, policy makers and program administrators should clarify and define ACH infrastructure functions and, where appropriate, explicitly recognize supporting these functions as an allowable use of funds and facilitate their coordination across program funding streams.
健康责任社区（ACHs）是跨越医疗、公共卫生和社会服务领域的合作性伙伴关系，旨在通过解决住房、食品安全、就业和交通等健康的社会决定因素来改善个人和社区的健康状况。ACHs不仅需要为项目和服务提供资金，还需要为核心基础设施功能提供资金。我们进行了一项法律和政策审查，以确定专门用于ACH基础设施活动的潜在资金来源。我们在联邦和州层面以及公共卫生、医疗保险、慈善和私营部门发现了多种可靠的选择。这些选择可以直接支持ACH基础设施，也可以通过报销与项目工作相关的行政成本来提供支持。然而，我们也发现，对于这些关键功能，没有专门或明确的资金来源。为了实现对ACH的可持续长期支持，政策制定者和项目管理人员应明确界定ACH基础设施功能，并在适当情况下明确承认将支持这些功能作为资金的允许用途，并促进它们在各项目资金流之间的协调。
