Overview
Introduction
fact sheet
Health and Human Services
What Does It Mean?
New Orleans and Louisiana residents have very low overall health as compared to the rest of the country. They suffer from high rates of obesity, heart disease, cancer deaths, and chronic health problems. Residents who are African American, economically disadvantaged, and/or uninsured are more likely to have significant health issues.
More than half of New Orleans residents report difficulty accessing care. However, the majority of pregnant women in Louisiana receive adequate prenatal care, and Louisiana residents report roughly as many sick days as the national average. Statewide, per capital funding for public health and per capita access to primary care both increased from 2007 to 2008.
Health
- Louisiana ranked 50th in the nation in overall health in 2015
- Infant mortality rate in Louisiana in 2015: 8.4 deaths per 1,000 live births (3rd highest in the nation).
- Cancer death rate in Louisiana in 2015: 217.9 deaths per 100,000 people (4th highest in the nation).
- Leading cause of death in Louisiana in 2015: Cardiovascular disease
- Rate of binge drinking in Louisiana in 2015: 16 percent (25th highest in the nation)
- Prevalence of obesity in Louisiana in 2014: 34.9 percent (4th highest in the nation)
- Percentage of pregnant women in Louisiana who received adequate prenatal care in 2011: 77.1.
- Average number of sick days per month Louisiana in 2011: 4.2 (7th in the nation).
- Percentage of New Orleans adults without health insurance in 2011: 19 (down from 26 percent in 2006).
- Percentage of New Orleans residents reporting some type of chronic health condition in 2011: 56.
- Percentage of New Orleans residents reporting trouble accessing health care in 2008: 68.
- Percentage decrease in access to primary care for Louisiana residents from 2008 to 2013: 1.3 (from 119.4 to 117.9 primary care physicians per 100,000 residents).
- Increase in public health funding per resident in Louisiana from 2008 to 2013: $95 to $99.
- Number of hospitals open in New Orleans as of 2016: 14 (as compared to 23 before Hurricane Katrina).
- African Americans in New Orleans were significantly more likely than whites to have fair or poor general health (28 percent compared with 19 percent) and report having no personal doctor (31 percent compared with 22 percent) in 2014.
- African American residents of Louisiana had a significantly higher cardiovascular death rate than other races in 2015.
- Economically disadvantaged New Orleans residents in 2007 ranked their health as “fair” or “poor” more than twice as often as those with higher economic status (19 percent compared with 9 percent).
- Uninsured New Orleans residents in 2008 were 1.5 times more likely to report their health status as “fair” or “poor”.
- Before Hurricane Katrina, over two-thirds of healthcare for the uninsured in New Orleans was provided by the Medical Center of Louisiana at New Orleans (MCLNO/Charity Hospital).
- Patients at MCLNO/Charity before Katrina were about 75 percent African-American and about 85 percent very low-income
Mental Health
- Percentage of New Orleans adults who ranked their mental health as “fair” or “poor” in 2010: 14 (down from 20 percent in 2008).
- Percentage of New Orleans adults in 2010 who reported having been diagnosed with a serious mental illness: 16 (up from 15 percent in 2008).
- Average number of poor mental health days per month for Louisiana residents in 2013: 4 (10th lowest in the nation).
What Does It Mean?
New Orleans residents already have high rates of mental illnesses like depression and Post Traumatic Stress Disorder (PTSD) and the number of diagnoses continues to climb each year. However, Louisiana residents overall report relatively few poor mental health days as compared with the nation.
fact sheet
Health and Human Services
Children and Seniors
- In 2015, Louisiana ranked 48th in the nation for child well-being based on ten indicators.
- Percentage of children in New Orleans living in poverty in 2014: 43 percent.
- Percentage of pre-Katrina childcare centers open in New Orleans in January, 2016: 55 (150 out of 273).
- Median annual cost for one infant in a Class A child care center in New Orleans in 2014: $5,975 (12.8 percent of median household income).
- Percentage of qualified New Orleans families receiving child care assistance vouches in 2008: 38.
- Percentage of Louisiana children served by afterschool programs in 2016: 15.
- Percentage of New Orleans senior citizens in need of health and supportive care: 16
- The percentage of New Orleans citizens over 65 was 11.5% in 2014 and is projected to increase by
What Does It Mean?
Children in New Orleans have very poor overall health and wellness as compared to children in the rest of the
nation. Over a third of New Orleans children live in poverty. While the average cost of child care is unaffordable for the average household, just over one-third of qualified households received childcare vouchers. Less than a quarter of children are served by afterschool programs.
While 16 percent of seniors are in need of health and supportive care, several area programs provide daytime programs and services for senior residents.
There is a need to plan for the inclusion of citizens over 65 years of age, an age group which is projected to dramatically increase by 5% by the year 2030.
Public Safety and Criminal Justice
- In 2013, Louisiana had the highest incarceration rate in the nation. (1,420 per 100,000 adults)
- In 2013, Louisiana had a higher rate of detained and committed youth as compared to the national average (180 per 100,000 youth, compared with 173 nationally).
- In 2013, the cost of detaining a juvenile offender in Louisiana was more than $141,000 annually—more than three times the cost in some other states.
- In 2006, the rate of detained and committed Louisiana youth in custody was 149 per 100,000 youth ages 10-15, in comparison to the national rate of 125.
What Does It Mean?
New Orleans has a higher rate of detained and committed youth and a higher overall crime rate than the national average.
Homelessness
- As of January, 2015, there were an estimated 1,700 homeless individuals in the City of New Orleans—less than half of a percent of the city’s total population.
- Number of emergency shelter beds in New Orleans as of 2015: 472.
- Percentage of homeless residents in 2012 who had some form of disability: 79.
- Percentage of homeless residents in 2008 who had more than one form of disability: 31.
What Does It Mean?
An estimated 0.43 percent of the total population of city was homeless as of January, 2015, the majority of whom
had some form of disability. There are far fewer available emergency shelter beds than there are homeless residents.
Sources: United Health Foundation, 2015; Louisiana Public Health Institute, 2015; Kaiser Family Foundation, 2015; Brookings Institute/Greater New Orleans Community Data Center, 2015; Bring New Orleans Back Health and Human Services Commission, 2015; Kessler et all, 2008; Agenda for Children, 2008. Afterschool Alliance, 2016. New Orleans Community Health Improvement Report, 2013. The Sentencing Project 2016. Louisiana Housing Corporation, 2016.
Findings
- Louisiana ranks among the worst states in the nation for several metrics of overall health, including chronic conditions such as obesity and heart disease.
- Socioeconomic disparities in health outcomes continue to persist for New Orleans and Louisiana residents.
- Access to health care among New Orleans residents has increased since Hurricane Katrina due to the proliferation of community-based clinics. However, a lack of specialty and mental health care persists.
- The overall health and wellness of children in Louisiana is poor compared with national averages.
- A relatively high percentage of children in New Orleans live in poverty, but the vast majority of them have health insurance.
- The majority of New Orleans children are not served by out-of-school-hours programs.
- The average cost of child care for one child in New Orleans is prohibitively expensive for the average New Orleans household.
- Homeless rates in New Orleans continue to surpass most other U.S. cities. Supportive housing and increased services such case management, outreach, emergency shelters, and daytime centers are needed for homeless individuals.
- New Orleans senior citizens’ highest-priority needs include low-cost medication assistance, transportation assistance, and daytime programming and care.
- New Orleans continues to rank very high in the nation in overall crime, but plans to transform the city’s criminal justice system are being implemented by a coalition of criminal justice leaders.
Challenges
- Sustaining and growing the network of neighborhood-based community health centers.
- Coordinating health care and human services in order to reduce redundancy, increase efficiency in service provision, and close service gaps.
- Providing adequate mental health and addiction treatment services, including transitional outpatient care.
A note on education
A
note on education: This chapter includes discussion of lifelong educational opportunities outside of regular school hours, including early childhood and day care for youth, afterschool opportunities for all school-age children, and day care and services for seniors. Workforce development for adults is discussed in Chapter 9—Economic Development. A comprehensive plan for New Orleans public school facilities—the School Facilities Master Plan for Orleans Parish* - was adopted by the school districts in 2008. The implications of this plan for the physical development of the city are discussed in Chapter 14—Land Use Plan. See: www.sfmpop.org
Acronyms
To aid in reading this section, below is a list of acronyms used within the text:
ACT |
Assertive Community Treatment |
NOAH |
New Orleans Adolescent Hospital |
BHAN |
Behavioral Health Action Network (a program of the |
NOPD |
New Orleans Police Dept. |
CAO |
Chief Administrative Officer |
NOPJF |
New Orleans Police and Justice federation |
CDBG |
Community Development Block Grant |
NORA |
New Orleans redevelopement Authority |
CHIP |
Children’s Health Insurance Program |
NORD |
New Orleans Recreational Department |
CJLA |
Criminal Justice Leadership Alliance |
OPSIS |
Orleans PArish Information Sharing and Integrated Systems (a program of the New Orleans Police and Justice Foundation) |
CZO |
Comprehensive Zoning Ordinance |
OFICD |
Office of Facilities; Infrastructure, and Community Development |
CPC |
City Planning Commission |
NORA |
New Orleans Redevelopment Authority |
D-CDBG |
Disaster Community Development Block Grant |
OFICD |
Office of Facilities, Infrastructure and Community
Development |
LDHDSS |
Lousiana Department of Health Department of Social Services |
PATH |
Partnerships for Access to Health Care (a program of the Louisiana public health Institute)
|
LaChip |
louisiana Children's Health Insurance Program |
UNOP |
Unified new orleans plan |
LPHI |
Louisiana Public health Insitiute |
|
|
MHSD |
Metropolitan Human Services District (a division of the Department of Health and Hospitals) |
|
|
MSC |
Multi-service center |
|
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A Introduction
A
robust and integrated system of health care and human services contributes to quality of life by promoting competitiveness, productivity and livability. While access tohealth care among New Orleans residents has increased since Hurricane Katrina with the proliferation of community-based clinics, new hospitals, and the expansion of Medicaid in Louisiana, and most New Orleans children have health insurance,Louisiana performs poorly on many measures of overall health, and socioeconomic disparities in health outcomes persist in New Orleans. The city suffers from inequitable health outcomes for a range of measures including infant mortality and chronic disease rates, which must be addressed through more equitable social, economic, and environmental conditions in addition to improved access to health care. Lack of affordable day care and insufficient afterschool programs affect children and youth, while at the other end of the age continuum the priority needs for senior citizens are affordable medications, transportation assistance and daytime programming and care. The city has higher rates of homeless persons than most other U.S. cities. Criminal justice reform initiatives and police efforts are directed at the city’s high crime rate.
The Master Plan focuses on organizing the physical and spatial aspects of providing health care and human services to New Orleans residents, as well as coordinating programs and initiatives. Non-governmental agencies provide most of these services, but city government can shape and assist the provision of services by designating and promoting locations for facilities, as well as by convening agencies working toward similar outcomes and leveraging funding to promote program coordination, efficiency, and quality. Because of the influence of social, economic and environmental factors on health, City government can also promote “health in all policies;” namely, the consideration of how policies and decisions made across sectors can affect health equity.
B Recommendations
A recommendations Summary linking goals, strategies and actions appears below and is followed by one or more early action items under the heading Getting Started. The Narrative follows, providing a detailed description of how the strategies and actions further the goals. Background and existing conditions to inform understanding of the goals, policies, strategies and actions are included in Volume 3, Chapter 8.
Summary
Next Five Years 2016-2021
2016-2021
Goal |
Strategy |
Actions |
How | Who | When | Resources |
1. Neighborhood-based centers that coordinate and deliver a broad range of health and human services tailored to the populations they serve and are accessible to all residents | 1.A. Coordinate partnerships between health and human service providers and owners/tenants of publicly- accessible facilities to provide for the location of multiple health and human service providers in shared locations
| 1. Create and maintain a database of publicly-accessible facilities that could house health and human service providers. |
Health Department; CAO; Property Management |
First five years |
OFICD 2009 budget provides $25 M for health institutions and hospitals |
2. Use current data on population and service needs to identify under served areas and locate new MSCs and other health and human service providers in areas of greatest need. |
CPC; Health Department; LDH |
First five years |
LPHI; Greater New Orleans Community Data Center; LDH; DSS; college and
university research institutes and others |
3. Offer incentives to property owners and tenants of potential shared use facilities to accommodate health and human service providers. |
Health Department; Community Development |
Medium-term |
OFICD 2009 budget provides $25 M for health institutions and hospitals |
1.B. Provide for the location of MSCs and other needed health and human service facilities— including supportive housing—in zoning and other land use regulations
| 1. Consult with homeless housing providers (UNITY and other advocacy groups) and other service delivery agencies in creating new regulations. |
CPC |
First five years |
UNITY of Greater New Orleans can provide information on zoning conducive to
supportive housing development |
1.C. Involve neighborhood and community groups and other stakeholders in decisions about the location and development of MSCs, and the type of services that should be provided
| 1. Use the Neighborhood Participation Plan to ensure meaningful community input. |
Capital Projects |
First five years |
Neighborhood Participation Plan (See Chapter 15) |
1.D. Ensure transportation linkages to established MSCs to ensure accessibility. Many individuals who would benefit from a MSC do not have adequate or reliable transportation to get there.
| 1. Coordinate or develop transportation services to/from nonemergency appointments for all Medicaid recipients. |
RTA, LDH, Local rideshare companies |
First five years |
Medicaid expansion |
2. Medicaid expansion | 2.A. Support and promote ongoing initiatives to convene a citywide health care consortium and a citywide human services consortium
| 1. Ensure full participation of all relevant public agencies in consortia meetings and initiatives. |
Health Department; MHSD; DHH; DSS; private and non-profit providers |
First five years |
Build on existing coalitions including Fit NOLA and the Behavioral Health Council. |
2. Coordinate partnership with the City Health Department and Fit NOLA to develop and implement a full range of strategies focused on reducing obesity among New Orleanians. These strategies should support and build upon existing Master Plan Goals, strategies and actions in five key areas: • Improve access to healthy foods • Address the surplus of unhealthy foods in our everyday environments • Raise awareness about the importance of healthy eating to prevent childhood obesity • Encourage physic |
Health Department; non-profit organizations |
First five years |
Grants, philanthropic resources |
2.B. Streamline City-administered grant funding processes for health and human services
| 1. Convene all grant administering offices to establish a more efficient application and granting process. |
All City agencies that administer grants to health, human service and related local agencies. |
First five years |
Consult with grant recipients to better understand their needs and realities. |
2.C. Support the development of a coordinated system of record-keeping, intakes and referrals throughout all levels of heath care service provision
| 1. Convene a task force to streamline citywide service referral and directory services. |
CAO (3-1-1); United Way (2-1-1) |
First five years |
Health and Human Services consortia should be consulted to ensure that the system
meets needs of all types of providers |
2.D. Prioritize support and funding for health and human services that provide comprehensive case management and/or coordinated care across disciplines and over time
| 1. Advocate for completion of the Neighborhood Place at Mahalia Jackson School. |
Health Department; Mayor’s Office; School Board |
First five years |
Advocate at state level for implementation of planned Neighborhood Place |
2. Implement ACT teams and support other resources that increase the availability of comprehensive case management. |
LDH; DSS; MHSD |
First five years |
CDBG; philanthropic funding |
3. A robust continuum of health care and human services, including preventative
care, that is accessible to all residents | 3.A. Ensure continued funding and support for community-based health clinics, including their certification as Patient-Centered Medical Homes
| 1. Advocate for increased funding from Medicaid. |
Public-private partnerships founded through health care consortium |
First five years |
Medicaid; Federally Qualified Health Centers; philanthropic funding |
2. City health officials and other city leaders can advocate at the state and federal levels for expansion of Medicaid eligibility requirements to increase the number of people insured. Increased Medicaid coverage will provide more reimbursements to health clinic providers and decrease their reliance on city and private funding. Additionally, greater flexibility in the state’s ability to use Medicaid Disproportionate Share dollars for outpatient primary care (currently only available for inpatien |
Mayor’s Office; Health Department |
First five years |
Federal funding (Health Care Financing Administration) |
3. Seek private philanthropic funding. |
Mayor’s Office; Health Department |
First five years |
Federal funding (Health Care Financing Administration) |
3.B. Support and enhance efforts to increase health insurance coverage for all residents
| 1. Advocate at the state level for increased funding and expanded eligibility for public insurance programs such as LaCHIP, Medicaid and Medicare. |
Mayor’s Office; Health Department |
First five years |
Federal funding (Health Care Financing Administration) |
2. Provide support and funding for local outreach programs to identify and enroll eligible residents in available insurance programs. |
Health Department; City Budget |
First five years |
Kingsley House’s Health Care for All program |
3. Increase access to information about what Medicaid expansion means for local residents. |
Health Department, LDH, 504HealthNet, local Federally Qualified Health Centers |
First five years |
Grants |
3.C. Navigating the world of health insurance is complicated, and information about insurance plans is not always easily accessible. Efforts should be made to not only inform individuals of their eligibility for insurance programs such as Medicaid, but to help them understand how to use their insurance and what it covers.
| 1. Direct public funding to expand programs such as the Nurse Family Partnership, Head Start, Healthy Start, and other programs that increase the health of children. |
Health Department; City Budget |
Medium-term |
philanthropic funding; CDBG |
3.D. Expand mental health and addiction treatment services and facilities to meet current and projected need
| 1. Advocate for increased state funding for LDH and MHSD for mental health services, including expanded ACT teams and permanent supportive housing. |
LDH; MHSD |
First five years |
CDBG |
2. Coordinate with the Behavioral Health Council to identify and target areas of need in mental and behavioral health and addiction treatment |
Health Department, LDH, MHSD |
First five years |
Baptist Community Ministries, City general funds |
3. Work with the Behavioral Health Council and other initiatives to facilitate partnerships between service providers to offer mental health services through existing community clinics and other health care facilities. |
Community clinics;
Behavioral Health Council; mental
health service providers |
First five years |
MHSD; LDH; DSS |
3.E. Support and enhance preventive and public health education and programs
| 1. Identify priority strategies and resources to address health education and outreach needs through engaging in community health improvement assessments and planning. |
New Orleans Community
Health Improvement Steering
Committee, Health Department |
First five years |
City general funds, grants |
3.F. Review need for and effective use of hospital facilities and emergency health care services and infrastructure according to data on projected population and need
| 1. Convene a hospital and emergency care advisory group within the citywide health care consortium (see above) to facilitate the aggregation and use of data in hospital and emergency health care planning. |
LDH; hospital and emergency care advisory group, Health Department, health care systems |
First five years |
OFICD Budget; City Budget |
3.G. Support and enhance programs and partnerships that promote sexual and reproductive health and teen pregnancy prevention
| 1. 1. Increase awareness of services that provide screening, testing, and education for all ages, especially school-aged students. |
LDH, Health Department, Schools, LPHI |
First five years |
LDH, LPHI, Grants |
3.H. Provide for emergency planning to ensure continuity of operations and services
| 1. Identify and address gaps in continuity of operations plans for all health and human service providers. |
LDH, Health Department, Schools, LPHI |
First five years |
LDH, LPHI, Grants |
4. Access to fresh, healthy food choices for all residents | 4.A. Establish and promote fresh produce retail outlets within walking distance of all residents
| 1. Identify areas that are under served by fresh food access. |
CPC; Community Development |
First five years |
Tulane Prevention Research Center |
2. Remove zoning and regulatory barriers to farmers’ markets and other temporary/mobile fresh food vending. |
CPC |
First five years |
CZO under development |
3. Explore incentives and provide technical assistance and training for small neighborhood food stores to stock fresh and local produce in under served areas. |
OCD, Health Department |
First five years |
City can offer expediting permitting as an incentive; grants. |
4. Encourage and assist farmers’ markets to accept food stamps and Seniors/WIC Farmers’ Markets Nutrition Program coupons. |
Health Department; local WIC administrators |
First five years |
Several area farmers’ markets already accept WIC and other food assistance coupons |
5. Support urban agriculture and community gardens. See Chapter 13—Environmental Quality. |
OFICD; CPC |
First five years |
Federal funding; bonds; philanthropic resources |
6. Explore and implement incentives to encourage sale of fresh and local food. |
City’s Economic Development Team |
First five years |
Grants |
4.B. Support access to healthy nutrition opportunities at government-run or supported facilities including (but not limited to healthy foods and beverages, availability of breastfeeding spaces, and availability of fresh water
| 1. Amenities to be included (but are not limited to) healthy foods and beverages, availability of breastfeeding spaces, and availability of fresh water. |
City, State, non-profit organizations |
First five years |
Federal, State and City funds / grants |
4.C. Explore avenues to address unhealthy food choices
| 1. Explore land use and zoning policies that restrict fast food establishments near school grounds and public playgrounds. |
City Planning Commission, City Council |
First five years |
Staff time |
2. Explore local ordinances to restrict mobile vending of calorie-dense, nutrient-poor foods near school grounds and public playgrounds. |
City Council |
First five years |
Staff time |
3. Promote consumer education and programming to facilitate healthy eating habits and support demand for fresh and local produce. |
Health Department, Fit NOLA Partners, Food Policy Advisory Council |
First five years |
Grants |
4. Educate residents about and promote advocacy to limit proliferation of fast food and drive thru establishments. |
Health Department, Fit NOLA Partners, Food Policy Advisory Council |
First five years |
Grants |
4.D. Promote business development for farmers and processors of locally grown food
| 1. Reduce zoning and regulatory barriers to processing and distribution of “value added” local food products. |
City Planning Commission, City Council |
First five years |
Staff time |
2. Promote training and instruction in food and plant production and processing. |
Local universities |
First five years |
Grants |
3. Encourage and support urban agriculture and community gardens through linkages with land use, water management, and economic opportunity plans. |
City Planning Commission, NORA, Sewerage and Water Board, Network for Economic
Opportunity, Health Department |
First five years |
Staff time, grants |
5. High-quality child care and learning opportunities beyond basic education that
are accessible to all children | 5.A. Expand after school and youth programs to serve all New Orleans children. As of 2007, only 25 percent of qualified school-aged children were served by after school programs. For more information, see Volume 3, pages 8.16–8.17.
| 1. Pursue increased funding from state and federal sources for after school and youth programs. |
City, with local private and non-profit providers and advocates |
First five years |
Twenty-first Century Learning Center Program; No Child Left Behind; Child
Care Development Fund; CDBG; Temporary Assistance to Needy Families;
Section 8(g) Grant Program |
2. Increase outreach to provide Child Care Development Fund vouchers to all who are eligible. |
DSS; CDBG; philanthropic funds |
First five years |
Provide information through health clinics, Nurse Family Partnership and similar programs for expectant families and MSC |
3. Provide for the location of needed child care and afterschool facilities in zoning and other land use regulations. |
CPC |
First five years |
CZO under development |
4. Provide support and incentives to child care service providers to become accredited through both national and state accreditation programs. |
Non-profit organizations |
First five years |
Agenda for Children offers training and technical assistance to child care providers As of 2009, only three child care facilities in New Orleans were nationally accredited. For more information, see Volume 3, Chapter 8. |
5. Prioritize new program development in areas of greatest need. |
Prioritize program development in areas of greatest need |
First five years |
Agenda for Children; Afterschool Partnership and others can provide data on service needs |
6. Support workforce development programs that train professional childcare workers. |
New Orleans Economic Development Council |
Medium-term |
Local colleges and universities |
6. High-quality supportive services for the elderly that are accessible to all
elderly residents | 6.A. Expand elder care facilities and services in areas of greatest need
| 1. Identify and expand elder care facilities and services in areas of greatest need. |
DHH; MHSC |
First five years |
Council on Aging can provide data on service needs. |
6.B. Provide affordable paratransit service for seniors
| 1. Advocate for increased funding for paratransit from RTA. |
RTA; Council on Aging |
First five years |
Council on Aging had a paratransit program in the past; requires additional funding
to restart it |
2. Provide public funding for taxi vouchers for low-income seniors. |
Community Development Council on Aging |
Medium-term |
Staff time; Federal grants |
6.C. Create an Age Friendly New Orleans Working Group to guide an age friendly strategy for the city to better support its seniors and allow for aging in place
| 1. Bring together people knowledgeable about senior needs as a working group charged with advising on Age Friendly policies for the city. |
AARP Louisiana, New Orleans Council on Aging, with a diverse stakeholder
group. |
First five years |
Staff Time of participating organizations and volunteers |
7. A robust continuum of care for homeless individuals and families | 7.A. Provide additional funding and support for outreach and safety net services for homeless persons
| 1. Advocate for increased funding at state and federal levels. |
LDH |
First five years |
Council on Aging can provide data on service needs. |
7.B. Provide for the location of permanent supportive housing, emergency shelters and daytime service centers for the homeless in land use and zoning
| 1. Incorporate into CZO. |
CPC |
First five years |
CZO under development |
2. Explore opportunities to use existing vacant buildings to house homeless individuals and provide wraparound services |
Community Development, Health Department |
First five years |
City and State resources |
7.C. Support programs and services that prevent homelessness through financial counseling and emergency assistance to at-risk households
| 1. City convening diverse working group to develop strategic plan to end homelessness. |
City Administration, City Council, business community, faith-based community,
Continuum of Care (Unity), HUD, DHH, DOJ, USICH |
First five years |
HUD, philanthropic community |
2. Provide financial support to homeless-serving agencies so they can offer financial management and job sustainability classes to homeless individuals. |
Community Development |
First five years |
City, State, Federal, philanthropic resources |
8. A criminal justice system that is effective, efficient, and just, and that emphasizes prevention and rehabilitation | 8.A. Support and expand community-based crime prevention programs that target high-risk and vulnerable populations
| 1. Implement and support evidence-based strategies and programs such as CeaseFire New Orleans and Group Violence Reduction Strategy. |
Mayor’s office, NOLA FOR LIFE |
First five years |
Advocate for increased public funding and apply for private funds. |
2. Address conflicts and trauma among youth through promotion of positive behavioral interventions and supports and trauma-informed approaches in schools. |
Schools, Health Department, Center for Restorative Approaches, Behavioral Health Council |
First five years |
Grants |
8.B. Expand evidence-based alternative sentencing, diversion, and community corrections programs for nonviolent offenders that emphasize comprehensive rehabilitation
| 1. Redirect criminal justice funding to support community corrections as opposed to incarceration. |
Parish Criminal Sheriff |
First five years |
Juvenile Detention Alternatives Initiative program of the Annie E. Casey Foundation |
25. Expand workforce readiness opportunities for people with criminal records. |
Economic Development Council; private service providers |
Medium-term |
CDBG; private funding |
3. Investigate creation of a state Community Corrections Act or similar legislation to provide funding for community corrections programs. |
State legislators |
Medium-term |
36 other states have similar legislation that can be used as precedent |
4. Fund mental health and substance abuse diversion programs at courts. |
City Council, Health Department |
First five years |
City funds, grants |
8.C. Support and expand Community Policing and neighborhood involvement in crime prevention
| 1. Work with neighborhoods to identify crime-related blight and call in enforcement. |
NOPD; OFICD (Code Enforcement) |
First five years |
Neighborhood Participation Program can be used to organize system |
2. Prioritize funding for community policing and new satellite police stations. |
NOPD |
Medium-term |
General funds |
8.D. Provide support for re-entry in accordance with best practices
| 1. Provide discharge planning and case management to link formerly incarcerated individuals with health and human service providers and ensure quality of care. |
OPSO, Volunteers of America |
First five years |
Referrals and communication with service providers |
2. Reduce barriers to opportunity for formerly incarcerated individuals, such as for housing and jobs. |
OPSO, Volunteers of America, HANO |
First five years |
Legislative advocacy |
8.E. Provide for other appropriate approaches to preventing and responding to violence
| 1. Promote a coordinated, victim-centered approach to respond to domestic violence and sexual assault. |
Health Department, NOPD, New Orleans Family Justice Center |
First five years |
Grant funding |
2. Promote prevention and education regarding the physical and sexual abuse of children. |
Health Department, Children’s Advocacy Center, Children’s Bureau |
First five years |
Grant fund |
3. Coordinate to prevent human trafficking, including labor and sex trafficking. |
Covenant House, Human Trafficking Task Force of GNO, NOPD |
First five years |
Share resource manual, referral system. |
Getting Started
These items are short-term actions that can be undertaken with relatively little expenditure and will help lay the groundwork for the longer-term actions that follow.
- Create and maintain a database of publicly-accessible facilities that could house health and human service providers.
- Facilitate partnerships to provide for the location of health and human service providers in existing community centers and other publicly-accessible facilities.
- Convene citywide consortia on health care and human services that meet regularly and include stakeholders from public, private and nonprofit sectors.
- Direct public health funding to expand outreach to and enrollment of eligible residents in low-cost or free insurance programs.
- Advocate for the Neighborhood Place at the Mahalia Jackson School to be fully implemented.
- Ensure that all available funds for child care are drawn down from state and federal sources.
- Expand outreach to all eligible families to receive Child Care Development Vouchers.
Narrative
Below is a more detailed narrative of the various goals, strategies and actions highlighted in the "Summary" chart.
2.8.1 Neighborhood-based centers that coordinate and deliver a broad range of health and human services tailored to the populations they serve and are accessible to all residents
The term “multi-service center” (MSC) is used here to describe neighborhood- based service centers that provide a range of coordinated health and human services across the continuum of care. This nomenclature is intended to reflect the broadest range of possibilities for collaboration across all health and human service sectors, and encompasses the multitude of forms that those collaborations may take as the concept of the MSC is implemented throughout New Orleans to reflect and meet the specific needs of individual communities. Although they do not go by this same term, there are several service providers in New Orleans that already successfully embody this model by providing a range of multiple, coordinated services, including health care, case management, behavioral health, and programming for children and youth
Services offered in any one location should be tailored to the specific population served. An MSC is likely to include multiple service providers within a single location, including public, private and nonprofit entities
By supporting and coordinating existing providers and facilitating partnerships and co-location in key locations, the City can ensure that all neighborhoods have access to an MSC that provides the services they desire and need. The range of services that can be provided through MSCs includes:
- A “medical home” for the coordination and delivery of primary health care and other health care services, including primary and preventative care, care for chronic diseases, and outpatient mental and behavioral health. (A “medical home” is not a residence, but rather a central point of coordination of care for all health-related services. See Volume 3, page 8.4–8.5 for more explanation of medical homes.)
- Case management, coordination and delivery of human and social services.
- Daytime programs and services such as day care and after school programs for youth, daytime programs for seniors, and literacy and workforce development programs for adults.
- Access to and information about publicly-sponsored services such as food stamps, unemployment, social security, disability assistance, transportation and day care vouchers, housing assistance, and literacy and workforce development programs.
- Resources, information, public education and outreach on public health and preventative health topics.
- A database of evacuation needs of residents within the service area, including special needs populations, and coordination of services to ensure continuous medical, mental health, and social service care in the event of an evacuation or other emergency.
- Access to centralized, up-to-date information on services and providers citywide to ensure a “no wrong door” approach to care and referrals that provides efficient and coordinated delivery of services across the continuum of care. The “no wrong door” approach ensures that a client requiring services that are not provided in a given location can be easily referred to the appropriate provider with confidence that system-wide coordination will prevent redundancy and expedite the referral and service delivery processes.
2.8.1.A 1.A. Coordinate partnerships between health and human service providers and owners/tenants of publicly- accessible facilities to provide for the location of multiple health and human service providers in shared locations
Fit NOLA
MSCs should be centrally-located where they are most accessible to the population they serve. The long-term goal is for every resident to have easy access to an MSC. The model of co-location of health and human services with public and centrally- located facilities such as schools, libraries, places of worship, and community and recreational centers is widely regarded as a national best practice, and has been a central tenet of numerous plans since Hurricane Katrina, including the public school facilities master plan and the UNOP and Neighborhood Rebuilding (Lambert) plans. Co-location of multiple services is not only economical, it also encourages a more robust sociocultural infrastructure that promotes greater coordination and community building.
Co-located services should include services that are compatible with one another and the surrounding neighborhood environment, and exclude incompatible services, such as emergency health care facilities within primarily residential areas, that could be disruptive to the surrounding neighborhood.
To create a citywide network of MSCs, NORA, the Department of Property Management, the Office of the CAO, City Planning, and other public agencies should facilitate public-private partnerships and shared-use agreements with existing publicly-accessible facilities to secure shared locations for health and human service providers. The City Planning Commission, through the Neighborhood Participation Program described in Chapter 15 of this plan, should work with neighborhood residents to ensure that MSCs are developed with community input at every stage and result in facilities that are an appropriate “fit”—in both physical and operational character— with the surrounding neighborhood context.
2.8.1.A.1 Create and maintain a database of publicly-accessible facilities that could house health and human service providers.
- Who: Health Department; CAO; Property Management
- When: First five years
- Resources: OFICD 2009 budget provides $25 M for health institutions and hospitals
Many cities and towns maintain a database of vacant commercial properties for the purpose of attracting businesses to locate there (often maintained by a local economic development agency). City Planning, in coordination with other city agencies (e.g., Health Department, NORA, CAO, and Property Management, as well as the Economic Development Council) and other public and nonprofit health initiatives, could develop and maintain a similar database of potential locations for MSCs and individual health and human service providers. The database should track owner and operator contact information, facility specifications, and cost, and should eventually be geocoded and mapped to include service needs by neighborhood. Maintaining the database would require regular and consistent outreach by City Planning staff to building owners and managers and other city agencies (e.g., schools, libraries, NORD, etc.) to keep the database up to date.
Such a database could be part of a more comprehensive citywide Asset Management Program, as discussed in Chapter 15—Structures for Implementation.
2.8.1.A.2 Use current data on population and service needs to identify under served areas and locate new MSCs and other health and human service providers in areas of greatest need.
- Who: CPC; Health Department; LDH
- When: First five years
- Resources: LPHI; Greater New Orleans Community Data Center; LDH; DSS; college and
university research institutes and others
Several local and regional entities collect and make available data on health outcomes, population demographics, and other factors that should be used to identify under served and at-risk populations when locating new services and facilities. Relevant data is currently available from LPHI, the Greater New Orleans Community Data Center, DHH, DSS, college and university research institutes, and other sources.
Developing new MSCs also presents an opportunity to target public investment in ways that contribute to neighborhood revitalization and quality of life. As such, reuse of existing vacant or under utilized publicly owned facilities—including community centers and schools (both functioning schools and land banked buildings)—should be given strong consideration as potential locations for health and human service providers since these facilities are typically centrally-located within neighborhoods. Many also have historic value and could help achieve simultaneous goals of preserving neighborhoods’ historic character, as discussed elsewhere in this plan (see Chapter 5—Housing and Neighborhoods, and Chapter 6—Historic Preservation).
2.8.1.A.3 Offer incentives to property owners and tenants of potential shared use facilities to accommodate health and human service providers.
- Who: Health Department; Community Development
- When: Medium-term
- Resources: OFICD 2009 budget provides $25 M for health institutions and hospitals
Incentives could include tenant improvements to facilities or contributions toward maintenance costs.
2.8.1.B 1.B. Provide for the location of MSCs and other needed health and human service facilities— including supportive housing—in zoning and other land use regulations
Land use and zoning should support the development of health and human service facilities, including supportive housing and MSCs, in circumstances of both adaptive reuse of existing structures and new development, and should also ensure that these facilities are pedestrian- and transit-accessible and compatible with the existing physical character of their surroundings. Health and human service facilities and MSCs should be located in or near neighborhood commercial districts wherever feasible.
2.8.1.B.1 Consult with homeless housing providers (UNITY and other advocacy groups) and other service delivery agencies in creating new regulations.
- Who: CPC
- When: First five years
- Resources: UNITY of Greater New Orleans can provide information on zoning conducive to
supportive housing development
2.8.1.C 1.C. Involve neighborhood and community groups and other stakeholders in decisions about the location and development of MSCs, and the type of services that should be provided
The development of the first Neighborhood Place in Sabine Parish involved successful collaboration among state and local service providers, community members, and other stakeholders. It will be governed by a board of consumers and community members to ensure that it continues to serve the unique needs of that community. In New Orleans, decisions about the location of new MSCs and the types of services they provide should be shaped by similar collaborative processes involving nearby residents, property owners, and others whom the new facility will serve. The Neighborhood Participation Program outlined in Chapter 15 of this plan provides an organized structure for this type of meaningful community input into decisions related to neighborhood development.
2.8.1.C.1 Use the Neighborhood Participation Plan to ensure meaningful community input.
- Who: Capital Projects
- When: First five years
- Resources: Neighborhood Participation Plan (See Chapter 15)
2.8.1.D 1.D. Ensure transportation linkages to established MSCs to ensure accessibility. Many individuals who would benefit from a MSC do not have adequate or reliable transportation to get there.
2.8.1.D.1 Coordinate or develop transportation services to/from nonemergency appointments for all Medicaid recipients.
- Who: RTA, LDH, Local rideshare companies
- When: First five years
- Resources: Medicaid expansion
2.8.2 Medicaid expansion
To fully embody a “no wrong door” approach to providing a comprehensive range of human services, significant coordination across all sectors and service providers is needed.
2.8.2.A 2.A. Support and promote ongoing initiatives to convene a citywide health care consortium and a citywide human services consortium
Two citywide consortia—one for health care and one for human services—including providers, consumers, and other stakeholders from private, public and nonprofit sectors should convene regularly to ensure efficient and effective health care and human service delivery and increase the capacity of the network of providers throughout the region. These consortia should be based on principles such as:
- Truly shared, collaborative governance composed of stakeholders from various sectors.
- Informed by, built upon or built into existing relevant structures.
- Existing coalitions include Fit NOLA and the Behavioral Health Council, both convened by the City of New Orleans Health Department.
- Embodying a regional, systems approach to health and human service policy.
- Promoting best practices with evidence-basis, based on local and national experience.
- Active engagement of the community.
- A culture of openness, mutual respect and accountability.
- Cross-membership between the two consortia.
Goals and activities of the consortia should include: Convening meetings of committed members within which to present their problems and resources to the consortium and community at large.
- Implementing actions to create coordinated systems of care, diminishing duplication and promoting efficient and accessible delivery of services.
- Instilling transparency and accountability into the delivery of effective services.
- Promoting the development and sustainability of service capacity of area providers through analysis, planning, decision-making and advocacy around changes to policy, programming and resource allocation.
- Developing, partnering in or otherwise advocating for requests for funding.
- Providing technical assistance to committed partners for implementation of initiatives. Developing and periodically updating shared priorities through application of consensus prioritization principles to most recent, valid and reliable data such as those from current population estimates, vital data, risk and disease data, service utilization data and community assets assessment.
2.8.2.A.1 Ensure full participation of all relevant public agencies in consortia meetings and initiatives.
- Who: Health Department; MHSD; DHH; DSS; private and non-profit providers
- When: First five years
- Resources: Build on existing coalitions including Fit NOLA and the Behavioral Health Council.
City health and human service agencies should be full and active participants in these consortia, and should contribute resources from meeting space to data to funding wherever appropriate to ensure their continued success. A representative from each relevant city and local public agency (e.g., DHH, MHSD, Health Department, DSS, etc.) should appoint at least one representative to serve as the liaison to the relevant consortia. Consistent representation will help promote collaborative relationships over time.
2.8.2.A.2 Coordinate partnership with the City Health Department and Fit NOLA to develop and implement a full range of strategies focused on reducing obesity among New Orleanians. These strategies should support and build upon existing Master Plan Goals, strategies and actions in five key areas: • Improve access to healthy foods • Address the surplus of unhealthy foods in our everyday environments • Raise awareness about the importance of healthy eating to prevent childhood obesity • Encourage physic
- Who: Health Department; non-profit organizations
- When: First five years
- Resources: Grants, philanthropic resources
2.8.2.B 2.B. Streamline City-administered grant funding processes for health and human services
Private and nonprofit service providers in New Orleans report that they are often deterred from applying for available city-administered grants because of cumbersome administrative burdens. Having a single source of city-administered funding and a common application process for multiple funding sources would increase the effectiveness of these funds by broadening the applicant pool and making the funds easier to use.
2.8.2.B.1 Convene all grant administering offices to establish a more efficient application and granting process.
- Who: All City agencies that administer grants to health, human service and related local agencies.
- When: First five years
- Resources: Consult with grant recipients to better understand their needs and realities.
City offices who administer grant funding should convene and establish within 6 months a strategy for streamlining funding and granting processes. The city’s web site should be utilized and application materials made available in downloadable format. A single contact person should be identified and their contact information posted on the web site to field all initial inquiries about applying for city-administered funding. Once a streamlined process is established and implemented, the group of funders should continue to meet at least annually to ensure continued coordination.
2.8.2.C 2.C. Support the development of a coordinated system of record-keeping, intakes and referrals throughout all levels of heath care service provision
2.8.2.C.1 Convene a task force to streamline citywide service referral and directory services.
- Who: CAO (3-1-1); United Way (2-1-1)
- When: First five years
- Resources: Health and Human Services consortia should be consulted to ensure that the system
meets needs of all types of providers
In the spirit of fostering a seamless continuum of care, numerous organizations have developed in-house resource guides to locally-available services, but no two lists are the same, and all require significant effort to compile and keep up-to-date. This is not only time- consuming for providers, but it also puts consumers at risk of “falling through the cracks” because providers are not always aware of other services available or do not have a reliable means of communicating with providers in other service sectors. The health care and human services consortia described above can be utilized to form a single focus groups to investigate ways to streamline and/or consolidate the various service referral and directory resources throughout the city, including VIALINK (2-1-1),2 3-1-1,3 504HealthNet,4 and others to avoid duplication of efforts and make the most efficient use of collective resources.
;As of 2009, United Way was working on legislation to develop a dedicated federal funding source for the development of 2-1-1 systems nationwide, and estimates that a fully realized 2-1-1 system that meets national standards will cost approximately $1.00–$1.50 per capita. The University of Nebraska’s Public Policy Center estimates that a fully realized 2-1-1 system in Nebraska will bring $7.4 million in benefits to the state of Nebraska with a population of 1.7 million. 5 The City should support efforts to bolster the current 2-1-1 system to provide increased coordination among health and human service providers as well increased as consumer information, and consolidate other duplicative services
2.8.2.D 2.D. Prioritize support and funding for health and human services that provide comprehensive case management and/or coordinated care across disciplines and over time
2.8.2.D.1 Advocate for completion of the Neighborhood Place at Mahalia Jackson School.
- Who: Health Department; Mayor’s Office; School Board
- When: First five years
- Resources: Advocate at state level for implementation of planned Neighborhood Place
In 2010, the state plans to open a Neighborhood Place at the Mahalia Jackson School. It would serve as a “one-stop shop” of state services—a single location housing representatives from DSS, LDH, the Department of Education, the Louisiana Workforce Commission, and the Office of Juvenile Justice. For more information, see Volume 3, p. 8.13.)
2.8.2.D.2 Implement ACT teams and support other resources that increase the availability of comprehensive case management.
- Who: LDH; DSS; MHSD
- When: First five years
- Resources: CDBG; philanthropic funding
(For more information on ACT teams, see Volume 3, Chapter 8.)
2.8.3 A robust continuum of health care and human services, including preventative
care, that is accessible to all residents
2.8.3.A 3.A. Ensure continued funding and support for community-based health clinics, including their certification as Patient-Centered Medical Homes
Community clinics funded by the LPHI administered Primary Care Access Stabilization Grant (PCASG) and other community-based clinics throughout New Orleans have not only filled critical gaps in health care provision since Hurricane Katrina, they also embody the Medical Home model of care which has been a central tenet of health care reform initiatives in New Orleans and throughout the state for more than a decade. (For more information on the Medical Home model, see Volume 3, page 8.4–8.5.) Additionally, several have expanded the services they provide to include outpatient behavioral and social services in addition to primary care, and exemplify coordinated, patient-centered service delivery across the continuum of care. These clinics represent an opportunity to reform the city’s health care system according to national best practices, and should serve as a foundation for a citywide network of neighborhood-based MSCs.
To ensure the continuation and expansion of community clinics in New Orleans after the 2010 expiration of the PCASG, the City should pursue the following sources of funding:
2.8.3.A.1 Advocate for increased funding from Medicaid.
- Who: Public-private partnerships founded through health care consortium
- When: First five years
- Resources: Medicaid; Federally Qualified Health Centers; philanthropic funding
City health officials and other city leaders can advocate at the state and federal levels for expansion of Medicaid eligibility requirements to increase the number of people insured. Increased Medicaid coverage will provide more reimbursements to health clinic providers and decrease their reliance on city and private funding. Additionally, greater flexibility in the state’s ability to use Medicaid Disproportionate Share dollars for outpatient primary care (currently only available for inpatient hospital care) can provide a stable source of funding for community
health clinics.
Note: Medicaid was expanded in Louisiana as of July 2016.
2.8.3.A.2 City health officials and other city leaders can advocate at the state and federal levels for expansion of Medicaid eligibility requirements to increase the number of people insured. Increased Medicaid coverage will provide more reimbursements to health clinic providers and decrease their reliance on city and private funding. Additionally, greater flexibility in the state’s ability to use Medicaid Disproportionate Share dollars for outpatient primary care (currently only available for inpatien
- Who: Mayor’s Office; Health Department
- When: First five years
- Resources: Federal funding (Health Care Financing Administration)
City health officials and other city leaders can advocate for the expansion of the Federally Qualified Health Center (FQHC) program in the New Orleans Region and the state to bring it in line with levels of funding received by states and regions with similar needs. This would allow existing FQHCs to expand their service provision and would also provide resources for new grantees. For more information on FQHCs, see Volume 3, p. 8.3-8.4.
2.8.3.A.3 Seek private philanthropic funding.
- Who: Mayor’s Office; Health Department
- When: First five years
- Resources: Federal funding (Health Care Financing Administration)
Support seeking grant funding for providing care for the uninsured. Public agencies such as the Health Department and local offices of MHSD and DHH should partner with existing networks of providers to secure private funding from foundations and other sources for health care initiatives.
2.8.3.B 3.B. Support and enhance efforts to increase health insurance coverage for all residents
While there are several exemplary programs that work to increase insurance coverage for New Orleans residents (enumerated in Volume 3, chapter 8), none of them currently serves its target audience completely due to lack of funding or capacity or both. Surveys of uninsured residents indicate that many are low-income (see Volume 3, chapter 8), and are therefore likely to qualify for low-cost or free insurance programs like LaCHIP, Medicaid or Medicare. Expanding outreach programs to identify and enroll qualified residents in insurance programs is an early-action item the city can take that is likely to offer significant return on investment. Increasing insurance coverage is not only likely to improve the health outcomes of enrollees, but will also bring needed funding to providers in the form of reimbursements and reduce indigent residents’ dependence on emergency rooms for basic care.
2.8.3.B.1 Advocate at the state level for increased funding and expanded eligibility for public insurance programs such as LaCHIP, Medicaid and Medicare.
- Who: Mayor’s Office; Health Department
- When: First five years
- Resources: Federal funding (Health Care Financing Administration)
(See Strategy 3.A, above.)
2.8.3.B.2 Provide support and funding for local outreach programs to identify and enroll eligible residents in available insurance programs.
- Who: Health Department; City Budget
- When: First five years
- Resources: Kingsley House’s Health Care for All program
Public health funding such as CDBG funds should be directed to organizations that already provide outreach to enroll residents in health insurance programs (such as Kingsley House’s Health Care for All program). Prioritizing programs that work to ensure all residents will provide significant return on investment and should be an early-action item.
2.8.3.B.3 Increase access to information about what Medicaid expansion means for local residents.
- Who: Health Department, LDH, 504HealthNet, local Federally Qualified Health Centers
- When: First five years
- Resources: Grants
Navigating the world of health insurance is complicated, and information about insurance plans is not always easily accessible. Efforts should be made to not only inform individuals of their eligibility for insurance programs such as Medicaid, but to help them understand how to use their insurance and what it covers.
2.8.3.C 3.C. Navigating the world of health insurance is complicated, and information about insurance plans is not always easily accessible. Efforts should be made to not only inform individuals of their eligibility for insurance programs such as Medicaid, but to help them understand how to use their insurance and what it covers.
Investing in the health and development of children—including prenatal care—is has been proven to provide significant return on investment in terms of the health, education, wellness and prosperity of children and their families for the rest of their lives.
2.8.3.C.1 Direct public funding to expand programs such as the Nurse Family Partnership, Head Start, Healthy Start, and other programs that increase the health of children.
- Who: Health Department; City Budget
- When: Medium-term
- Resources: philanthropic funding; CDBG
2.8.3.D 3.D. Expand mental health and addiction treatment services and facilities to meet current and projected need
Mental health care and addiction treatment stand out as a significant unmet need in New Orleans, and while the rate of mental illness appears to be on the rise, local mental health providers have lost public funding in recent years. (NOAH, the only inpatient mental health facility for the uninsured in the city is scheduled to close in 2010). Advocates for increased mental health care in New Orleans include a range of interest groups, from health, housing and homeless assistance initiatives to public safety and criminal justice advocates to real estate and business interests, who recognize the connection between providing adequate care and nurturing an investment-friendly environment.
2.8.3.D.1 Advocate for increased state funding for LDH and MHSD for mental health services, including expanded ACT teams and permanent supportive housing.
- Who: LDH; MHSD
- When: First five years
- Resources: CDBG
Called “one of the most ambitious social-service experiments of our time” by The New York Times and recognized as a “best practice” nationally, the Harlem Children’s Zone (HCZ) project is a unique, holistic approach to ensuring that children stay on track through college and go on to the job market. The HCZ pipeline begins with Baby College, a series of workshops for parents of children ages 0–3, and goes on to include best-practice programs for children of every age through college. The network includes in-school, after- school, social-service, health and community-building programs.
The two fundamental principles of The Zone Project are to help kids as early in their lives as possible and to create a critical mass of adults around them who understand what it takes to help children succeed. All services are provided free of charge. Recent evaluations showed that 100 percent of students in the HCZ pre-Kindergarten program were school-ready for six consecutive years and 97.4 percent of eighth graders were at or above grade level in math. The budget for the HCZ Project for fiscal year 2009 is more than $40 million, or an average of $3,500 spent annually per child. One-third of funding comes from a public sources and two-thirds comes from private and philanthropic sources.
In 2008, Louisiana state legislation SR122 requested the Department of Social Services, the Department of Health and Hospitals, and the Department of Education to conduct a joint study and develop a comprehensive continuum of support for Louisiana’s children using the Harlem Children’s Zone as a model.
2.8.3.D.2 Coordinate with the Behavioral Health Council to identify and target areas of need in mental and behavioral health and addiction treatment
- Who: Health Department, LDH, MHSD
- When: First five years
- Resources: Baptist Community Ministries, City general funds
The the Beahvioral Health Councill will gather data on service coverage and needs in the New Orleans area. Future investments should make use of this data to target investment where it is needed most and where it will offer the highest returns.
2.8.3.D.3 Work with the Behavioral Health Council and other initiatives to facilitate partnerships between service providers to offer mental health services through existing community clinics and other health care facilities.
- Who: Community clinics;
Behavioral Health Council; mental
health service providers
- When: First five years
- Resources: MHSD; LDH; DSS
Since Hurricane Katrina, several community clinics have branched out to offer mental and behavioralhealthservices through partnerships with other providers. (See Volume 3, pages 8.7–8.8.) The City can encourage other clinics to follow this example by offering incentives and facilitating partnerships and shared-use agreements between primary care clinics and behavioral health care providers.
2.8.3.E 3.E. Support and enhance preventive and public health education and programs
INTERGENERATIONAL DAYCARE
Combined daycare facilities for young children and seniors that give seniors the option to participate in structured intergenerational activities with children are gaining popularity around the country. Studies have shown that elderly adults who participate in structured activities with children on a regular basis are more focused and in better moods than when children are not involved. Compared to their peers in traditional preschools, children in intergenerational daycare programs are more patient, express more empathy, exhibit more self-control and have better manners.
Supporting preventative and public health initiatives is another cost-effective investment the city can make in the health and well-being of its residents. Facilitating partnerships with neighborhood, faith-based, and other community organizations to work with public health initiatives can increase the reach of these programs to serve a broader population.
2.8.3.E.1 Identify priority strategies and resources to address health education and outreach needs through engaging in community health improvement assessments and planning.
- Who: New Orleans Community
Health Improvement Steering
Committee, Health Department
- When: First five years
- Resources: City general funds, grants
This group should coordinate and collaborate on efforts to extend public health education and outreach by applying jointly for funding and otherwise collaborating.
2.8.3.F 3.F. Review need for and effective use of hospital facilities and emergency health care services and infrastructure according to data on projected population and need
Hospitals and other emergency health care services and infrastructure (e.g., EMS, fire and police) are critical to ensuring a robust continuum of health care services. The health care industry is also an important component of the future economic prosperity for New Orleans and the region. Development of new hospital and emergency infrastructure should be driven by data on population demographics and areas of need within the health care sector (e.g., types of specialties, etc.).
2.8.3.F.1 Convene a hospital and emergency care advisory group within the citywide health care consortium (see above) to facilitate the aggregation and use of data in hospital and emergency health care planning.
- Who: LDH; hospital and emergency care advisory group, Health Department, health care systems
- When: First five years
- Resources: OFICD Budget; City Budget
See also: Chapter 10—Community Facilities and Services for a discussion of emergency services and infrastructure.
2.8.3.G 3.G. Support and enhance programs and partnerships that promote sexual and reproductive health and teen pregnancy prevention
New Orleans experiences high rates of sexually transmitted infections and teen pregnancy. It is important to inform and educate residents on the availability of prevention and testing services and provide them with information on how to make healthy decisions around sexual and reproductive health.
2.8.3.G.1 1. Increase awareness of services that provide screening, testing, and education for all ages, especially school-aged students.
- Who: LDH, Health Department, Schools, LPHI
- When: First five years
- Resources: LDH, LPHI, Grants
2.8.3.H 3.H. Provide for emergency planning to ensure continuity of operations and services
In light of New Orleans’ vulnerability to emergencies, it is critical for health and human service providers to engage in emergency preparedness planning and maintain continuity of operations plans.
2.8.3.H.1 Identify and address gaps in continuity of operations plans for all health and human service providers.
- Who: LDH, Health Department, Schools, LPHI
- When: First five years
- Resources: LDH, LPHI, Grants
2.8.4 Access to fresh, healthy food choices for all residents
2.8.4.A 4.A. Establish and promote fresh produce retail outlets within walking distance of all residents
2.8.4.A.1 Identify areas that are under served by fresh food access.
- Who: CPC; Community Development
- When: First five years
- Resources: Tulane Prevention Research Center
Work with local partners, including the Tulane Prevention Research Center, to establish a walkability standard for access to fresh produce outlets for all residents (e.g., 80 percent of households within ½ mile of outlets) and identify geographic areas throughout the city that are under served by fresh food outlets according to this standard. An example of this type of study is the New York City Supermarket Need Index6, which determines areas in the city with the largest populations with limited opportunities to purchase fresh food.
2.8.4.A.2 Remove zoning and regulatory barriers to farmers’ markets and other temporary/mobile fresh food vending.
- Who: CPC
- When: First five years
- Resources: CZO under development
2.8.4.A.3 Explore incentives and provide technical assistance and training for small neighborhood food stores to stock fresh and local produce in under served areas.
- Who: OCD, Health Department
- When: First five years
- Resources: City can offer expediting permitting as an incentive; grants.
Incentives might include: Financing (grants and loans) for capital improvements and equipment, inventory, and technical assistance; expedited permitting assistance with produce merchandising and promotion. See also: Chapter 5—Neighborhoods and Housing for strategies for attracting supermarkets and other neighborhood-serving retail.
2.8.4.A.4 Encourage and assist farmers’ markets to accept food stamps and Seniors/WIC Farmers’ Markets Nutrition Program coupons.
- Who: Health Department; local WIC administrators
- When: First five years
- Resources: Several area farmers’ markets already accept WIC and other food assistance coupons
2.8.4.A.5 Support urban agriculture and community gardens. See Chapter 13—Environmental Quality.
- Who: OFICD; CPC
- When: First five years
- Resources: Federal funding; bonds; philanthropic resources
2.8.4.A.6 Explore and implement incentives to encourage sale of fresh and local food.
- Who: City’s Economic Development Team
- When: First five years
- Resources: Grants
The 2009 OFICD budget provides $7 million in D-CDBG funds to establish a Fresh Food Retailers Grant/Loan Program, and an additional $2 million to establish a Community Markets Initiative and an Urban Food Gardens initiative. These funds—in addition to private and philanthropic funding—can be used for the above strategic actions. The City should work with stakeholders to assure that there is a business plan for the continuation of these initiatives after disaster fund. The CZO allows agriculture with products destined for commercial sale in most districts.
Initiatives to increase opportunities for participating in urban agriculture are discussed in Chapter 13—Environmental Quality.
2.8.4.B 4.B. Support access to healthy nutrition opportunities at government-run or supported facilities including (but not limited to healthy foods and beverages, availability of breastfeeding spaces, and availability of fresh water
2.8.4.B.1 Amenities to be included (but are not limited to) healthy foods and beverages, availability of breastfeeding spaces, and availability of fresh water.
- Who: City, State, non-profit organizations
- When: First five years
- Resources: Federal, State and City funds / grants
2.8.4.C 4.C. Explore avenues to address unhealthy food choices
2.8.4.C.1 Explore land use and zoning policies that restrict fast food establishments near school grounds and public playgrounds.
- Who: City Planning Commission, City Council
- When: First five years
- Resources: Staff time
2.8.4.C.2 Explore local ordinances to restrict mobile vending of calorie-dense, nutrient-poor foods near school grounds and public playgrounds.
- Who: City Council
- When: First five years
- Resources: Staff time
2.8.4.C.3 Promote consumer education and programming to facilitate healthy eating habits and support demand for fresh and local produce.
- Who: Health Department, Fit NOLA Partners, Food Policy Advisory Council
- When: First five years
- Resources: Grants
2.8.4.C.4 Educate residents about and promote advocacy to limit proliferation of fast food and drive thru establishments.
- Who: Health Department, Fit NOLA Partners, Food Policy Advisory Council
- When: First five years
- Resources: Grants
2.8.4.D 4.D. Promote business development for farmers and processors of locally grown food
2.8.4.D.1 Reduce zoning and regulatory barriers to processing and distribution of “value added” local food products.
- Who: City Planning Commission, City Council
- When: First five years
- Resources: Staff time
Many local growers and producers could earn more income by selling value added products beyond raw produce, but face barriers. Reducing such barriers would enhance the local food industry and facilitate business
development and improved livelihoods of local growers and producers.
2.8.4.D.2 Promote training and instruction in food and plant production and processing.
- Who: Local universities
- When: First five years
- Resources: Grants
2.8.4.D.3 Encourage and support urban agriculture and community gardens through linkages with land use, water management, and economic opportunity plans.
- Who: City Planning Commission, NORA, Sewerage and Water Board, Network for Economic
Opportunity, Health Department
- When: First five years
- Resources: Staff time, grants
2.8.5 High-quality child care and learning opportunities beyond basic education that
are accessible to all children
2.8.5.A 5.A. Expand after school and youth programs to serve all New Orleans children. As of 2007, only 25 percent of qualified school-aged children were served by after school programs. For more information, see Volume 3, pages 8.16–8.17.
2.8.5.A.1 Pursue increased funding from state and federal sources for after school and youth programs.
- Who: City, with local private and non-profit providers and advocates
- When: First five years
- Resources: Twenty-first Century Learning Center Program; No Child Left Behind; Child
Care Development Fund; CDBG; Temporary Assistance to Needy Families;
Section 8(g) Grant Program
Eighty-nine percent of all probation or parole violators are unemployed at the time of violation. CEO is an nonprofit employment agency for people with criminal records in New York City based on the idea that if the employment needs of persons with criminal convictions are addressed at their most vulnerable point—when they are first released from incarceration or soon after conviction—they will be less likely to become reincarcerated and more likely to build a foundation for a stable, productive life. CEO’s services include a highly structured program of pre-employment job readiness training, short-term paid transitional employment and full-time job placement and retention services. Findings from an independent evaluation show that program participants are 50 percent less likely to be reincarnated after joining the program.13
Investments in programs for children and youth have been show to provide dramatic returns in terms of both child and family wellness as well as cost savings to the municipalities in which they live. For instance, investments in high-quality pre-school education for low-income students show a $9 return for every $1 investment. Public funding is available for after school programs but has not been fully utilized by the city in recent years. Out of 33 discretionary federal programs identified as potentially funding after school programs, only 9 of them currently have awardees in New Orleans. The city should partner with child care providers and local advocates (such as the Afterschool Partnership and Agenda for Children) to apply for funds and ensure that all available funding is drawn down and used each year. Sources of available funds include:
- 21st Century Community Learning Center Program (21st CCLC): Louisiana is eligible to receive over $20 million each year to support afterschool programs; however, since 2004, the state has not drawn down the maximum amount of money dedicated for 21st CCLC programming.
- No Child Left Behind
- Child Care Development Fund (CCDF): The CCDF is designed to help provide child care to low income parents who work and/or attend school.
- Community Development Block Grants (CDBG): Currently, the City of New Orleans allocates $115,617 of the $15.5 million in CDBG funds it receives to youth programs.7
- Temporary Assistance to Needy Families (TANF): Louisiana dedicates $19–25 million each year in TANF funds to reimburse licensed child care centers.
- Section 8(g) Grant Program: Provides approximately $5.1 million in funds each year to exemplary or innovative programs designed to improve student academic achievement or skills.
2.8.5.A.2 Increase outreach to provide Child Care Development Fund vouchers to all who are eligible.
- Who: DSS; CDBG; philanthropic funds
- When: First five years
- Resources: Provide information through health clinics, Nurse Family Partnership and similar programs for expectant families and MSC
As of 2008, only 38 percent of qualifying families received the voucher. (For more information, see Volume 3, Chapter 8) The City can assist in facilitating partnerships with community organizations such as neighborhoods, schools, places of worship, and others to perform outreach to families with children.
2.8.5.A.3 Provide for the location of needed child care and afterschool facilities in zoning and other land use regulations.
- Who: CPC
- When: First five years
- Resources: CZO under development
2.8.5.A.4 Provide support and incentives to child care service providers to become accredited through both national and state accreditation programs.
- Who: Non-profit organizations
- When: First five years
- Resources: Agenda for Children offers training and technical assistance to child care providers As of 2009, only three child care facilities in New Orleans were nationally accredited. For more information, see Volume 3, Chapter 8.
2.8.5.A.5 Prioritize new program development in areas of greatest need.
- Who: Prioritize program development in areas of greatest need
- When: First five years
- Resources: Agenda for Children; Afterschool Partnership and others can provide data on service needs
The Agenda for Children, the Afterschool Partnership for Greater New Orleans, and other local and national advocacy organizations collect and make available data on service gaps in programs for youth. Partnering with these and other organizations to plan public investments in areas of greatest need will ensure the best return on investment.
2.8.5.A.6 Support workforce development programs that train professional childcare workers.
- Who: New Orleans Economic Development Council
- When: Medium-term
- Resources: Local colleges and universities
There is currently a nationwide shortage of well-trained and experienced child care workers. For more information on programs that provide workforce development in child care, see Volume 3, page 8.16. See Chapter 9 for further discussion on workforce development programs.
2.8.6 High-quality supportive services for the elderly that are accessible to all
elderly residents
2.8.6.A 6.A. Expand elder care facilities and services in areas of greatest need
To better serve all elderly residents with daytime care and activities, including social and recreational programs as well as health care services, additional facilities as well as expanded services in existing facilities should be developed according to data on service gaps and need. Priority should be given to development of services on or near transit routes and in or near other community and publicly-accessible facilities for maximum accessibility.
2.8.6.A.1 Identify and expand elder care facilities and services in areas of greatest need.
- Who: DHH; MHSC
- When: First five years
- Resources: Council on Aging can provide data on service needs.
2.8.6.B 6.B. Provide affordable paratransit service for seniors
In 2008, a survey of New Orleans-area seniors revealed that low-cost transportation assistance was among seniors’ most important issues. For more information, see Volume 3, p. 8.17.
2.8.6.B.1 Advocate for increased funding for paratransit from RTA.
- Who: RTA; Council on Aging
- When: First five years
- Resources: Council on Aging had a paratransit program in the past; requires additional funding
to restart it
2.8.6.B.2 Provide public funding for taxi vouchers for low-income seniors.
- Who: Community Development Council on Aging
- When: Medium-term
- Resources: Staff time; Federal grants
See also: Chapter 5—Housing and Neighborhoods for a discussion of housing for the elderly.
2.8.6.C 6.C. Create an Age Friendly New Orleans Working Group to guide an age friendly strategy for the city to better support its seniors and allow for aging in place
By 2030 the share of residents over the age of 65 is projected to increase by 5%. To prepare for this increase and better serve residents of all ages a plan should be made to make the city more age friendly.
2.8.6.C.1 Bring together people knowledgeable about senior needs as a working group charged with advising on Age Friendly policies for the city.
- Who: AARP Louisiana, New Orleans Council on Aging, with a diverse stakeholder
group.
- When: First five years
- Resources: Staff Time of participating organizations and volunteers
2.8.7 A robust continuum of care for homeless individuals and families
2.8.7.A 7.A. Provide additional funding and support for outreach and safety net services for homeless persons
With the extent of blight and vacancy in New Orleans, outreach workers for the homeless are stretched thin. Providing additional funding for outreach to the homeless is the only way to ensure that all homeless individuals have access to the network of services designed to move them into permanent housing and provide supportive services.
2.8.7.A.1 Advocate for increased funding at state and federal levels.
- Who: LDH
- When: First five years
- Resources: Council on Aging can provide data on service needs.
2.8.7.B 7.B. Provide for the location of permanent supportive housing, emergency shelters and daytime service centers for the homeless in land use and zoning
2.8.7.B.1 Incorporate into CZO.
- Who: CPC
- When: First five years
- Resources: CZO under development
2.8.7.B.2 Explore opportunities to use existing vacant buildings to house homeless individuals and provide wraparound services
- Who: Community Development, Health Department
- When: First five years
- Resources: City and State resources
2.8.7.C 7.C. Support programs and services that prevent homelessness through financial counseling and emergency assistance to at-risk households
2.8.7.C.1 City convening diverse working group to develop strategic plan to end homelessness.
- Who: City Administration, City Council, business community, faith-based community,
Continuum of Care (Unity), HUD, DHH, DOJ, USICH
- When: First five years
- Resources: HUD, philanthropic community
2.8.7.C.2 Provide financial support to homeless-serving agencies so they can offer financial management and job sustainability classes to homeless individuals.
- Who: Community Development
- When: First five years
- Resources: City, State, Federal, philanthropic resources
See Chapter 5—Housing and Neighborhoods for a discussion of permanent supportive
housing.
2.8.8 A criminal justice system that is effective, efficient, and just, and that emphasizes prevention and rehabilitation
In spring 2007, at the request of the New Orleans City Council, the Vera Institute of Justice proposed several initiatives to make the city’s criminal justice system more fair and effective based on national best practices. These recommendations led to formation of the Criminal Justice Leadership Alliance (CJLA). CJLA, working in partnership with the Vera Institute, has already completed ground-breaking work on this issue, implementation of which began in 2009 and holds great promise for transforming the criminal justice system in New Orleans. (For more information, see Volume 3, pages 8.22–8.23.) In addition, NOPJF’s OPISIS information-sharing system promises to increase communication and efficiency within the New Orleans criminal justice system. The City should prioritize the continued implementation of these plans. The recommendations below are intended to emphasize and support these plans.
NOLA FOR LIFE: A Comprehensive Murder Reduction Strategy was developed by the Mayor’s Innovation Delivery Team, in collaboration with the Police Department, Health Department, other City departments, as well as agencies and community members across New Orleans. NOLA FOR LIFE has utilized a public health approach to reducing violence since its launch in 2012. While the murder rate remains unacceptable, since the implementation of many initiatives under NOLA FOR LIFE we have seen a reduction in the murder rate, as well as decreased recidivism among NOLA FOR LIFE program participants.1
2.8.8.A 8.A. Support and expand community-based crime prevention programs that target high-risk and vulnerable populations
Stopping the cycle of violence and learned criminal behavior starts with preventing criminal activity before it begins. Studies show that afterschool, youth mentorship, and recreational programs are effective deterrents to criminal activity in young at-risk populations. 9Nonetheless, criminal justice professionals in New Orleans cite the dearth of youth programs and mental health and addiction treatment services as major impediments to an effective criminal justice system
2.8.8.A.1 Implement and support evidence-based strategies and programs such as CeaseFire New Orleans and Group Violence Reduction Strategy.
- Who: Mayor’s office, NOLA FOR LIFE
- When: First five years
- Resources: Advocate for increased public funding and apply for private funds.
Contributors to strategy development should include members of the criminal justice system, representatives from youth advocates such as the Afterschool Partnership, NOPD, NORD, MHSD, and other stakeholders.
2.8.8.A.2 Address conflicts and trauma among youth through promotion of positive behavioral interventions and supports and trauma-informed approaches in schools.
- Who: Schools, Health Department, Center for Restorative Approaches, Behavioral Health Council
- When: First five years
- Resources: Grants
2.8.8.B 8.B. Expand evidence-based alternative sentencing, diversion, and community corrections programs for nonviolent offenders that emphasize comprehensive rehabilitation
Alternative sentencing, also known as community corrections, is a strategy of serving low-level offenders such as first-time, nonviolent, and status offenders a sentence that can be served in a supervised community-based setting as opposed to in confinement. Community corrections have been shown to result in significant public savings. For example, while a day in detention in Cook County (IL) costs about $114, many young people are now supervised in the community by a youth advocate for $17 a day, or report nightly to a community center for intensive supervision and programming at a cost of $35 a day. Community corrections programs have also been shown to significantly reduce recidivism: Over 90 percent of the young people in Cook County’s detention alternatives remained arrest-free while in the programs.10The New Orleans criminal justice system offers some opportunities for community corrections for youth and adults, such as the successful Orleans Parish Drug Court and the District Attorney’s Diversion Program. However, criminal justice professionals suggest that these serve only a fraction of those eligible.
2.8.8.B.1 Redirect criminal justice funding to support community corrections as opposed to incarceration.
- Who: Parish Criminal Sheriff
- When: First five years
- Resources: Juvenile Detention Alternatives Initiative program of the Annie E. Casey Foundation
Louisiana State law explicitly allows the Orleans Parish Criminal Sheriff to establish and operate community rehabilitation centers within Orleans Parish for offenders who have “strong rehabilitation potential.”
11 Redirecting funds from incarceration facilities to community programs would increase the capacity of these programs to serve a higher percentage of eligible nonviolent offenders.
2.8.8.B.25 Expand workforce readiness opportunities for people with criminal records.
- Who: Economic Development Council; private service providers
- When: Medium-term
- Resources: CDBG; private funding
Prisoner re-entry programs that focus on employment and life skills have been shown to significantly reduce recidivism (see box above). Expanding such programs is a cost-effective means of reducing recidivism and reducing crime rates that could provide significant return on investment.
2.8.8.B.3 Investigate creation of a state Community Corrections Act or similar legislation to provide funding for community corrections programs.
- Who: State legislators
- When: Medium-term
- Resources: 36 other states have similar legislation that can be used as precedent
Thirty-six states have policies known as a Community Corrections Acts that provide funding to municipalities for community corrections programs.13For example, California’s Probation Subsidy Act, enacted in 1965, provided counties up to $4,000 for each prison-eligible offender who was supervised, sanctioned and serviced in the community. Between 1969 and 1972, the state placed nearly all nonviolent property offenders under local supervision, cut its inmate population by 30 percent, closed eight prison facilities and drove recidivism (within two years of release) down from 40 percent to 25 percent.14/15Louisiana currently has no such program, but city officials could collaborate with other municipalities in the state to investigate the potential cost savings and feasibility of implementing similar legislation.
2.8.8.B.4 Fund mental health and substance abuse diversion programs at courts.
- Who: City Council, Health Department
- When: First five years
- Resources: City funds, grants
The Community Alternatives Program at Municipal Court, run by the Health Department, is a diversion program that diverts defendants with mental illness to treatment in lieu of incarceration. This program fosters collaboration between mental health and criminal justice stakeholders. Since its inception in 2014 through July 2016, the program has served 111 participants.
2.8.8.C 8.C. Support and expand Community Policing and neighborhood involvement in crime prevention
2.8.8.C.1 Work with neighborhoods to identify crime-related blight and call in enforcement.
- Who: NOPD; OFICD (Code Enforcement)
- When: First five years
- Resources: Neighborhood Participation Program can be used to organize system
2.8.8.C.2 Prioritize funding for community policing and new satellite police stations.
- Who: NOPD
- When: Medium-term
- Resources: General funds
2.8.8.D 8.D. Provide support for re-entry in accordance with best practices
2.8.8.D.1 Provide discharge planning and case management to link formerly incarcerated individuals with health and human service providers and ensure quality of care.
- Who: OPSO, Volunteers of America
- When: First five years
- Resources: Referrals and communication with service providers
2.8.8.D.2 Reduce barriers to opportunity for formerly incarcerated individuals, such as for housing and jobs.
- Who: OPSO, Volunteers of America, HANO
- When: First five years
- Resources: Legislative advocacy
2.8.8.E 8.E. Provide for other appropriate approaches to preventing and responding to violence
2.8.8.E.1 Promote a coordinated, victim-centered approach to respond to domestic violence and sexual assault.
- Who: Health Department, NOPD, New Orleans Family Justice Center
- When: First five years
- Resources: Grant funding
2.8.8.E.2 Promote prevention and education regarding the physical and sexual abuse of children.
- Who: Health Department, Children’s Advocacy Center, Children’s Bureau
- When: First five years
- Resources: Grant fund
2.8.8.E.3 Coordinate to prevent human trafficking, including labor and sex trafficking.
- Who: Covenant House, Human Trafficking Task Force of GNO, NOPD
- When: First five years
- Resources: Share resource manual, referral system.