There have been few city governments in the U.S. that have had as many successful public/private partnerships as Wichita.

That’s why, early in the process, elected officials for Wichita, as well as Sedgwick County, were approached to provide funding for prescription medications for Project Access patients. And it was because of those past successful partnerships that this concept was not foreign to its elected officials, who could see very clearly how the government’s role was defined and how crucial it was to the success of the project. As city manager Chris Cherches observed “when I saw how Asheville was doing it, I could also see, based on the cost of this program, that the city and the county were going to have to be involved to make it work.” It was also a way the private sector could see that the public sector was doing its job and vice versa.

Which is pretty much the way it was sold to the governing body. “I thought this was one of those private/public partnerships that could be very successful,” said Mr. Cherches, “I supported the public sector’s involvement to help insure the program’s success.”

Indeed, a role was found for the public sector. Since cash for prescription medication assistance was needed, this would be where the government’s role should be (as opposed to donated services that the doctors and hospitals could provide). When Dr. Uhlig identified that role, everyone thought it made sense. Because if city representatives were ever questioned about where the money went, people could more easily understand an uncomplicated process of its use for prescription drugs. Mr. Cherches advised, “You have to be very careful how public funds are expended. I felt that by having it targeted to prescription drugs, it would be something easily identifiable — accountability was built into these expenditures.”

After being contacted by Dr. Uhlig, Chris Cherches went with other key leaders down to Asheville. “I didn’t know what I was going down there for. Why anyone from city government should go,” said Mr. Cherches. “But when I started finding out more about the program — more about how it could be applicable — I was very much impressed. And I pretty much stayed active thereafter.” Once convinced that city government should be involved, Mr. Cherches’ role became, as he put it, “a cheerleader who worked behind the scenes to get our governing body all lined up” to approve the program.

In the summer of 1999, at a joint meeting of the City Council and the County Commission, a group of partners introduced Project Access. Officials were impressed with all the preliminary work that was already completed. They also noted the enthusiasm of the doctors, who were all on board (which meant that a high value was already in place) and how Project Access was going to leverage the assets of the doctors and hospitals.

At that point, the only thing missing was the prescription drug component. So, city and county officials — seeing that their role was well-defined; their contribution specifically described — agreed to put up the money, responding generously with a first-year commitment totaling $500,000.

Officials thought it was a proper symbolic gesture to support the medical community through this program. What’s more, the city and the county were to have representation on the Operations Council, so they would have valuable input into the process. Officials recognized the kind of impact they could have in this project. So much so that, as Sedgwick County commissioner Tom Winters tells it, “issues were left at the door because it was felt that this was just too important.”

“I’ve always felt that health care is local,” said Peter Stern, executive director of the Prescription Network of Kansas. “Since they’re dealing with a very localized population, a county and a city government does not have to pull huge amounts of money out of their budget” for prescription drug support.

Today, funding from the City of Wichita (CSBG) and Sedgwick County is part of a yearly budget process. “I now automatically budget funds for this use, so it’s kind of embedded now,” said city manager Chris Cherches, “In fact, we’re trying to get Project Access to expand the program to provide dentistry, especially to children.” Mr. Stern adds, “I applaud the city and the county for coming to bat on this. The money they give could be used on other services. But, on the other hand, it’s very little and it goes a long way.”

The city and county are planning to be long-time partners in Project Access. Already, they have increased allocations to cover the rising cost of drugs. “I’ve made speeches to other city managers that they should take a look at this program and get involved in it and have it in their communities. Because we’ve seen the benefits of it,” said Mr. Cherches, who summed it all up by adding, “Not only is it a human benefit. But there’s a financial benefit as well — it can actually cut the costs to the community.”

NOT JUST DOLLARS, BUT SENSE.

And it wasn’t just money that government entities were bringing to the table. The state Medicaid agency, the office of Social and Rehabilitation Services (SRS) broke new ground, making a tremendous move that is rare in government management: they repositioned SRS staff to work full time in the area’s low-cost clinics. This was the beginning of a wonderfully new private/public relationship that has come to greatly benefit each other’s missions and the community as a whole.

“This program came to our agency at an opportune time,” admitted Paul Meals, chief of Adult and Medical Services at SRS, “Our agency Secretary clearly articulated that we shouldn’t do things in a traditional way; that we need to look at what the community’s needs are and try to accommodate them. That gave us more confidence that we’d be supported in trying to do things in a different way.”

They also utilized new technology to help make this happen. Technology that allowed SRS staff to do their eligibility work outside official state offices. For the first time, SRS staff could tap into the mainframes at the state offices from the field — in this case, the clinics themselves.

This newfound ability has had a tremendous effect. In every clinic, it is an SRS worker whose job it is to enroll people in Project Access after a doctor refers them for specialty care. Before this new partnership between Project Access, SRS and the clinics, patients would have to go downtown to the State Office Building and negotiate a bureaucratic maze — wait in line, go through security, etc. It was demeaning or intimidating for patients, or they didn’t have the transportation — so, naturally, many were either reluctant or unable to go there. Consequently, the state would miss out on the chance to provide those people with much-needed services.

Now SRS staff are more easily accessible to indigent patients. Project Access has made the state government more user-friendly and better able to serve the needs of the patients, many of whom were eligible for other publicly funded programs and weren’t taking advantage of them. And because of this new way of working, as more patients were found to be eligible for other programs, they became another income source for the hospitals rather than a continued recipient of costly donated services.

Meanwhile, patients soon developed the same trust towards SRS workers that they felt towards the clinics’ staff. And they are now assured of referrals to, and connections with, available community services. Indeed, as of December 2002, the SRS staff has reviewed 35,000 clinic patients for eligibility for a variety of programs including Medicaid, SCHIP, and Project Access. (Today, 70% of the enrollment in Project Access is processed by SRS outreach workers in the clinics.)

What’s more, all of the SRS staff embraced this move. Those with the best customer service skills, with a genuine interest in people and who could work effectively, were selected to work at the clinics. As a bonus, it became a good motivator for the staff. And when they began seeing tangible results of their efforts, they started feeling good about coming to work.

Even the medical providers began to see the SRS staff in a different light. With SRS staff a visible presence in the clinics, walls between clinic personnel and SRS staff started to come down. And everyone saw that SRS who, before Project Access, was the enemy that everyone loved to hate, were not all bad people and were really more of an ally rather than an opponent.

It turned out to be a great symbiotic relationship.