Group of Foundations Award a Total of $615,000 for Implementation

The Connecticut state legislature passed SustiNet, the new state health care reform law, in July 2009, when it overrode a veto by Gov. M. Jodi Rell (R). (For background on the law and the role of the Universal Health Care Foundation of Connecticut, read the GrantWatch Outcomes column in the September/October 2009 issue of Health Affairs.) An eleven-member SustiNet Board of Directors was charged with implementation of the law. However, the law did not provide enough money for sufficient staffing or for operations of the board, explained a recent press release.

That is where private philanthropy stepped in. On 18 May 2010, four foundations and the SustiNet board announced philanthropic support for the board, via an audio press briefing.

 Here is what the foundations are funding:

Universal Health Care Foundation of Connecticut: Its $150,000 in funding will support the work of Stan Dorn, a researcher at the Urban Institute, who will write what is called the “sixty-day report” on “how Connecticut can implement SustiNet within the context” of the federal health reform legislation enacted in March 2010; “the opportunities [that] federal reform offers to support SustiNet’s goals; and the ways in which the policy design of SustiNet needs to be adjusted” to mesh with federal reform, as Frances Padilla, the interim president of the foundation, explained in an e-mail following the briefing. The funding will also partially support dynamic economic modeling and analyses, as needed, by Jonathan Gruber, a professor of economics at the Massachusetts Institute of Technology (MIT). For example, he will project the cost of care under SustiNet and estimate how many people it will cover. Padilla also told me that the funding would “support communications/public information expertise for the SustiNet board.”

 ●Connecticut Health Foundation: $300,000 over one year (renewable)—one of its largest grants ever—to be used for a project management team affiliated with the University of Massachusetts Medical School’s Center for Health Law and Economics (in Charlestown, Massachusetts).

Jessie B. Cox Charitable Trust (which is based in Boston and funds throughout New England): $90,000 over one year for the partial costs of Gruber’s work, mentioned above. Through modeling, Gruber will be able “to examine the impact of different scenarios” to help the SustiNet board arrive at its recommendations for implementation, the trust’s Amy Segal Shorey explained in an e-mail.

Robert Wood Johnson Foundation (RWJF), through its State Coverage Initiatives national program: $75,000, to support the work of Stan Dorn. With these funds, he will provide technical assistance to the SustiNet board and will oversee and coordinate the policy work of SustiNet’s various task forces and committees.

In her opening remarks during the briefing, Padilla of the Universal Health Care Foundation commented that SustiNet “works hand-in-glove with federal reform.” Pat Baker, president of the Connecticut Health Foundation, said that the mission of that foundation is to improve the health status of people in Connecticut. She stated that philanthropy must partner effectively with government, other philanthropic groups, and the community. “No one can do it all,” she added.

Shorey of the Cox Trust noted that it had recently narrowed the scope of its health funding area—it now focuses on access to high-quality, affordable care—so the grant aiding SustiNet implementation is a good fit for that foundation. (See the trust’s new guidelines.) Enrique Martinez-Vidal, who directs the RWJF’s State Coverage Initiatives program, said that SustiNet was an “extraordinary accomplishment,” given the fiscal situation in which most states find themselves. However, some modifications will clearly have to be made to coordinate it with federal health reform, he commented.

Kevin Lembo, who is the official “healthcare advocate” for Connecticut (this is a state job) and serves as cochair of the SustiNet board, commented that the foundations’ funding was “timely and innovative” and will help the board to meet its statutory deadlines.

Nancy Wyman, the state comptroller and the other SustiNet board cochair, also made some opening remarks. She stated that because of state “fiscal conditions,” Connecticut could not move forward with implementation of the SustiNet law without this philanthropic support. She also mentioned that some 160 volunteers who are experts in such subjects as health information technology (IT), disease prevention, and quality of care, had worked on SustiNet committees over the past several months. Also, the SustiNet board has three task forces at work on obesity prevention among children and adults, tobacco and smoking cessation, and health care workforce concerns. As Connecticut implements state health reform, Wyman commented, the idea is to “capitalize on the features” of federal reform.

A Q & A session followed. In response to a reporter’s question, Lembo said that the SustiNet board is making an effort to collaborate with the three health reform–related boards that Governor Rell has established; those three panels, though, will expire when Rell’s term ends in January 2011. (She is nearing the end of her second term and will not run again; the general election for governor is in November 2010.) Padilla pointed out that “foundations stand the test of time” and go “beyond political interests.” They can ensure that the Connecticut SustiNet law is implemented.

In response to a question on the challenges of integrating SustiNet with the federal health reform legislation, Martinez-Vidal mentioned that the insurance exchange is included in the federal legislation, but not in SustiNet. In general, he sees opportunities for SustiNet and the federal legislation to fit together nicely; he does not foresee that any major changes to SustiNet will be required.

Padilla later commented that Connecticut can demonstrate to the United States how a state-offered health plan can be part of the insurance exchange, required under the federal legislation. Baker stated that Stan Dorn, the Urban Institute researcher, has said that there is nothing in SustiNet that has to be redesigned in order to comply with requirements of the new federal legislation; “just technical issues” will need to be fixed.

A discussion followed on when various reports and documents are due.

Here is the timeline:

Late May 2010: The “sixty-day report” to be written by Stan Dorn is delivered to the Connecticut General Assembly. The report will be posted at

1 July 2010: SustiNet committees and task forces “issue specific recommendations for SustiNet, based on their specific charges” in the Connecticut SustiNet legislation, Victoria Veltri, general counsel in Lembo’s office, explained in an e-mail.

January 2011: The SustiNet board submits a report to the state legislature with recommendations and/or draft legislation on implementing the SustiNet law, Veltri said. Gruber’s economic analysis will be part of the submission.

The above information comes from an audio press briefing held 18 May 2010 and from responses to follow-up questions addressed to some of the briefing participants.

Related Resource:

“Quick Question: What’s the Right Relationship between Philanthropy and Government?” GrantCraft released this four-page document on 19 May 2010; GrantCraft is funded by the Ford Foundation. This document begins: “It’s practically a given these days that philanthropy and government ought to work together.” In it, GrantCraft reports results from its online survey of more than 1,500 respondents. They responded to quotations from foundation leaders including Karen Davis of the Commonwealth Fund, Gara LaMarche of Atlantic Philanthropies, and Luis Ubiñas of the Ford Foundation.