Aug. 7, 2017

Batten’s Pay for Success Lab Helping to Fight Richmond's Asthma Problem

Reprinted from and a Richmond City Health District’s announcement.

Joshua Ogburn, Director of the Batten School’s Social Entrepreneurship @ UVa Pay for Success Lab, is the project manager for a year-long initiative to explore innovative funding methods to address childhood asthma in Richmond.

The Richmond City Health District has received $100,000 in cash and $250,000 in technical help from the Sorenson Impact Center of the University of Utah’s David Eccles School of Business.

The Richmond Pediatric Asthma Pay for Success Project will work with local hospitals, medical practitioners, health insurance companies, asthma service providers, local school systems, university researchers, state and local government officials, and affected children and families to develop ways to deal with the asthma problem.

Pay for Success is a performance-based contract between philanthropic investors, who provide upfront funding for a promising intervention, and an outcome payor, such as state or local government, that agrees to repay the investment based upon the achievement of specific outcome measures.

Pay for Success focuses limited public sector resources on interventions that measurably improve lives while doing so focused on results.

Pay for Success “has the potential to help find better ways to address problems,” Ogburn said.

“The University of Virginia Pay for Success Lab is excited to partner with the Richmond City Health District, the Sorenson Impact Center, and many other community partners on this exciting initiative. Pay for Success is a means to expand the most effective solutions to critical problems in localities across the nation,” Ogburn said.

“Given the widespread nature of pediatric asthma in the greater Richmond region, this initiative has the potential to improve the livelihoods of thousands of children and families.”

“This Pay for Success feasibility program has been a cornerstone to many advantageous Pay for Success projects across the country,” said Jeremy Keele, President & CEO of the Sorenson Impact Center. “We’re delighted to offer technical assistance and capacity-building to yet another cohort of government jurisdictions and non-profits that are dedicating themselves to making a measurable difference in people’s lives,” he said.

The Pay for Success Lab currently is recruiting student Fellows for the coming school year. Fellows focus on a specific issue area (such as pediatric asthma, green infrastructure, or the opioid crisis), identify localities across the country that are experiencing a problem in that issue area, and consult with local stakeholders to determine whether PFS can be an effective means to address their local issue.

The Fellowship is an excellent opportunity to learn about important policy issue areas, gain familiarity with evidence-based policy and impact investing, and create real change in communities. All UVA students are invited to apply.

Paid leadership positions and unpaid volunteer positions are available. The application link is available here. The due date is Sunday, August 27 at 11:59 p.m.


In Richmond, Michael Schechter, chief of the division of pulmonology medicine in the pediatrics department of the VCU School of Medicine, is monitoring the health of 400 children.

He is seeking to provide more of a continuum of care for the kids. In 2015 he helped create You Can Control Asthma Now (UCAN). The program focuses on providing solid medical care that’s personalized and relationship-based while also addressing social issues that affect health.

The name UCAN sends a positive message to families and promotes higher expectations, says Schechter.

Schechter says he expects to show the program results in reductions in emergency room visitation and hospitalization, and in improved asthma control. It also helps reduce the number of schooldays missed by the children, and the work time lost by their parents and other caregivers, he says.

Respiratory illnesses are the most common cause of hospitalization of children, and UCAN has cut the hospitalization rate in its children by half, Schechter says.

The program earned the Children’s Hospital of Richmond at VCU a National Environmental Leadership Award in Asthma Management from the U.S. Environmental Protection Agency. The award was presented in May and was one of three for 2017.

Asthma control is part of the focus of the Green and Healthy Homes Initiative, a national program to promote eco-friendly, energy-efficient and healthy homes for low- and moderate-income households.

Richmond’s Healthy Homes Coalition in June initiated the six-month process to participate in the initiative. There are 25 cities in the program, and Richmond would be the first in the commonwealth to join.

Richmond consistently placed in the top tier as one of the worst metro areas for asthma in rankings from the Asthma and Allergy Foundation of America. Richmond was second on its list for 2015, the most recent year for rankings. Asthma affects about 8.5 percent of children in the United States, but affects twice as many black children as white children.

Asthma can’t be cured, but it can be managed and treated.

There are numerous factors that can trigger asthma, including dust mites, pollen, mold, pet dander, cockroaches and rodents, smoke, chemicals and air pollution, exercise, and respiratory woes.

Economic and social disparities also come into play.

Schechter cites factors such as low expectations from families, poor insurance, lack of transportation and poor housing affecting management of asthma in children in inner-city Richmond. A child may, for example, only be seen by health care workers when they are in crisis in an emergency room, or at a clinic, instead of being managed consistently by the same team and building a “positive, trusting relationship,” Schechter says.

Joshua Ogburn (far right) leads a panel discussion during a Pay for Success conference.

Joshua Ogburn 
Director, SE@UVA (Social Entrepreneurship) Pay for Success Lab

(Read more about Josh’s work here.)