Helping Nursing Homes Prepare for Disasters; Hilton Foundation’s Lessons Learned in Disaster Grant Making


October 29th, 2012

As I sit here waiting for the worst of what we are to get from Hurricane Sandy to hit the Washington, D.C., area, I wanted to remind readers of a September 2010 GrantWatch article on nursing homes and disasters, such as hurricanes. In case you missed this article, following is some information about it. I also direct you to a March 2012 report from the Conrad N. Hilton Foundation on disaster grant making.

The GrantWatch section of Health Affairs published an article about a John A. Hartford Foundation initiative called Hurricane and Disaster Preparedness for Long-Term Care Facilities. The initiative was a response to the deaths of elderly residents at long-term care residences following Hurricanes Katrina, Rita, and Wilma back in 2005. Titled “Helping Nursing Homes Prepare for Disasters,” the article contains insights into successful grant making related to disasters and describes activities of the Hartford Foundation grantees. Read the rest of this entry »

RWJF Young Leader Award Winners Announced, as Foundation Celebrates Fortieth Anniversary


October 25th, 2012

The Robert Wood Johnson Foundation announced the winners today. Read below to find out a little about the ten Young Leader winners.

The Robert Wood Johnson Foundation (RWJF), based in Princeton, New Jersey, announced the ten winners of an award for young people with “strong potential for future leadership,” who are age forty or younger and are being recognized “for their exceptional contributions to improving the health of the nation,” according to an October 25 press release. Each winner will receive $40,000; these awards will be presented tomorrow.

This is a one-time awards program and ties in with the RWJF’s fortieth anniversary. As the foundation looked to the past to reflect on its accomplishments as it celebrates its anniversary, it “also wanted to look to the future,” to young leaders, born during the foundation’s existence, who have already achieved early successes and have the potential to improve health and health care in the United States, the RWJF’s president and CEO, Risa Lavizzo-Mourey, explained in the release. Read the rest of this entry »

Election 2012: Informational Resources on Health Care: What Have Foundations Funded?


October 19th, 2012

It’s election season, and I have noticed that a few foundations are funding information dissemination efforts—including a report, a toolkit, a video, and a post-election event. For those voters who remain undecided, perhaps these resources will help you make a decision—at least on who has the best health care platform!

Please note that this is just a selected sample of foundation efforts. I am fairly certain that there are more!

Analysis of Polling Data

The Henry J. Kaiser Family Foundation released three brief Data Notes (Kaiser analyses of data from polls or other sources) on October 12. For these three documents, the foundation is delving deeply into its polling and that of other organizations on health care issues, it explained.

One of the new documents is “Polling on Medicare Premium Support Systems over Time”; it looks at polling data, going back to 1995, on the subject of changing Medicare to such a system. Republican presidential candidate and former Massachusetts governor Mitt Romney supports this proposed change in which the federal government would provide Medicare beneficiaries “a fixed amount of money that could be applied toward the cost of health insurance purchased either from private insurers or [from] the traditional Medicare program,” Kaiser explained.

Another Data Note is titled “Seniors and the 2012 Presidential Election.” Drawing primarily upon two 2012 Kaiser polls, this document examines several questions, including how seniors view the Affordable Care Act of 2010 (ACA).

The other Data Note is “Whom Does the Public Trust More on Health Care and Medicare?” This is “a historical look at the public’s views of whom they trust more,” Republicans or Democrats, on these topics, and it analyzes these views in the context of the 2012 presidential election, Kaiser explained.

Report

The Commonwealth Fund issued an October 2012 report titled Health Care in the 2012 Presidential Election: How the Obama and Romney Plans Stack Up, by Sara R. Collins and colleagues, all from Commonwealth. The abstract for this fifty-eight-page report states that President Barack Obama and Romney offer “fundamentally different visions for the nation’s health system,” so the upcoming election “provides a stark choice for U.S. voters.” The report uses microsimulation analysis (conducted by Jonathan Gruber, an economist at the Massachusetts Institute of Technology) “to contrast the potential impact of implementing the Affordable Care Act in full” (Obama’s plan) with Romney’s plan “to repeal the law, eliminate many of the new requirements for insurance markets, and make changes in Medicare and Medicaid.”

The authors (whose views are “not necessarily those of The Commonwealth Fund or its directors, officers, or staff,” a disclaimer points out) conclude that in each of the seven criteria that they examined, full implementation of the ACA “would likely outperform” the Romney plan to repeal that law “and replace it with fewer federal requirements for insurance markets and reduced funding for the Medicaid and Medicare programs.” (Criteria include whether small businesses are helped and whether Medicare is improved.)

The authors explain that their conclusion is driven in part by there being more details available in the federal health reform law and in the new guidance and regulations from the U.S. Department of Health and Human Services than there are in Romney’s “far less detailed proposals to replace the law.” The authors also include a section on the methodology that they used.

Toolkit

The Robert Wood Johnson Foundation gave funding to the nonpartisan Alliance for Health Reform to produce a toolkit called “The Presidential Health Care Plans—What You Need to Know.” The alliance says that the toolkit “will help you to move beyond [the candidates’] rhetoric.” Read the rest of this entry »

People Post: News of Comings and Goings at Foundations; Philanthropy Awards Programs


October 16th, 2012

It is time to catch up on “people news” at foundations: who has a new job where, and who has been appointed to a foundation board. Also, Karen Davis and Dick Jackson were honored for their work—each by a different philanthropy. And a foundation staffer was named to the Institute of Medicine.

Lucia Corral Peña has been named the program officer for the Blue Shield of California Foundation’s program called Blue Shield Against Violence. She is managing its portfolio of grants focused on ending domestic violence in California. Before coming to the foundation, she was principal of Corral Peña Consulting, “where she worked with foundations and nonprofit clients to design and implement programs and strategies to address the needs of diverse populations,” the foundation says on its website. Corral Peña’s previous work includes being program director for the California Wellness Foundation’s Work and Health priority area, which promotes the health of low-income workers. She coauthored a peer-reviewed, Health Affairs GrantWatch article in 2002 titled “The California Wellness Foundation’s Grant Making in Work and Health.”

Speaking of the California Wellness Foundation, I read that Crystal D. Crawford has been appointed program director for two of its priority areas: diversity in the health professions and women’s health. She was previously CEO of the California Black Women’s Health Project. She holds a law degree from New York University School of Law and has also worked as an associate at corporate law firms.

Karen Davis, president of the Commonwealth Fund since 1995, received the Health Care Leadership Award from the United Hospital Fund “for her pioneering leadership in health care—locally, nationally, and internationally” and for her “productive career guided by the philosophy that all Americans should have access to the highest-quality health care,” according to an October 1 press release. Davis was one of three honorees at the United Hospital Fund’s annual gala held at the Waldorf-Astoria hotel in New York City. Davis will be retiring at the end of the year, as GrantWatch previously reported. She is the author of a 2005 peer-reviewed, Health Affairs GrantWatch paper, “Toward a High-Performance Health System: The Commonwealth Fund’s New Commission.”   Read the rest of this entry »

October Health Affairs: Update on Foundation Funding to Improve Minority Health and Reduce Disparities


October 11th, 2012

In my GrantWatch column in the print and online versions of Health Affairs’ October issue, I update readers on what foundations have been funding in these areas.

My column follows a year after a well-written, peer-reviewed GrantWatch paper by Faith Mitchell and Kathy Sessions on the same topics was published in our October 2011 issue.

Disparities persist—they have not gone away, from what I have read. What causes disparities? Is it just lack of access to medical care? No—residential segregation, race and racism, poverty, violence and environments lacking access to health food or safe places to exercise can play roles, says a recent Institute of Medicine (IOM) report funded by several foundations, including the California Endowment and others, as well as the Centers for Disease Control and Prevention (CDC).

I organized the column into descriptions of funding for a program to reduce disparities in diabetes; foundation-funded programs for the education and professional development of members of minority groups, including the recently re-named Mongan Commonwealth Fund Fellowship in Minority Health Policy (the Mongan part refers to the late Jim Mongan of Partners HealthCare); and foundation-funded publications on how the Affordable Care Act of 2010 can help to achieve health equity. Read the rest of this entry »

The Role of Philanthropy in Changing the Geriatric Mental Health and Substance Use Workforce


October 10th, 2012

The author served on the Institute of Medicine panel that wrote a recent report on the health professions workforce that will be needed to care for older people with mental illness and substance use conditions. He is executive director of the Hogg Foundation for Mental Health, in Austin, Texas.

The Institute of Medicine (IOM) report, The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands?, was released in June 2012. This report could not be timelier, especially given our current health care crisis, which has been fueled by insufficient budgets, fragmented delivery systems, and historically, an inability to efficiently and effectively implement innovation.

As a member of the committee that wrote the report, it was truly an educational and eye-opening experience. The state of the current health care infrastructure is quite overwhelming: nearly one in five older adults in America has one or more mental health and/or substance use conditions; the number of adults age sixty-five and older is projected to increase to more than 72 million by 2030; the pipeline for producing geriatric mental health/substance use personnel is woefully inadequate; and our geriatric mental health/substance use workforce policies are disjointed. And while the report offers five high-level policy recommendations to address the unique needs of our aging population, it also spells out challenges and needs that are opportunities for philanthropic organizations.

The creation of specific workforce initiatives to improve the development, education, and/or training of a geriatric mental health/substance use workforce would be grand, but an equally important step is to recognize the importance of inclusion. By “inclusion,” I mean, for example, developing (1) programs that target our physicians, nurses, nurse practitioners, physician assistants, and so forth to have training in geriatrics and geriatric mental health/substance use conditions included in their curricula; (2) programs that target our mental health/substance use specialists’ need to include training in geriatrics; and (3) programs focused on geriatric specialists’ need for training in mental health/substance use.

Any one of these areas could be tackled by a foundation interested in the health care workforce. Multiple strategies at the local, regional, and national levels are possible and, in fact, are needed to maximize the potential of our current workforce. Imagine funding awarded to an academic health center or to several academic health centers to develop the very skill sets outlined above. This could be at the medical school, nursing school, school of allied health professions, and/or the respective clinical or residency levels. There could be a separate grant program targeting providers after they have finished their formal training (that is, funding of continuing education). And what would be quite powerful would be a policy grant targeting the credentialing process as it relates to the skill sets needed to holistically take care of our aging population. Read the rest of this entry »

Report from the Field on a Kentucky Policy Forum on Integrating Medical and Behavioral Care


October 4th, 2012

GrantWatch Blog invited the author, who recently joined the staff of the Foundation for a Healthy Kentucky, to report on its recent Howard L. Bost Memorial Health Policy Forum, which was held in Lexington.

On September 17, the Foundation for a Healthy Kentucky held its tenth annual health policy forum in Lexington, Kentucky. (The forum was named the Howard L. Bost Memorial Health Policy Forum several years ago.) This year’s event was titled “No Wrong Door: Integrating Care for Better Health.” The forum addressed economic and human effects of providing medical and behavioral health services in a more seamless and systematic way. (The term “behavioral health” used here includes mental health and substance use services.) This year’s forum attracted more than 300 diverse community leaders, advocates, and health providers from around the state.

The day started with remarks by Kentucky’s secretary of health and family services, Audrey Tayse Haynes. Referencing the extensive evidence supporting integrated care, Haynes stated, “The jury is not out on the benefits of care integration.” She spoke of efforts by the State of Kentucky to integrate care and reiterated Kentucky’s commitment to having Kentucky Medicaid managed care integrate behavioral and physical health for those most vulnerable.

Renee Shaw of Kentucky Educational Television shared an excerpt from its soon-to-be-released No Health without Mental Health, a new hour-long documentary and studio health program in the station’s Health Three60 series, which is funded in part by the Foundation for a Healthy Kentucky.

Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, moderated the morning plenary panel, which included Joan Kenerson King of the National Council for Community Behavioral Healthcare; Steve Melek of Milliman actuaries; Todd Prewitt of Humana, the insurer; and Ben Miller of the Office of Integrated Healthcare Research and Policy at the University of Colorado, Denver. The panel addressed both the complexity and the potential of fully integrated care.

King used patient experiences to share a vision for integrated care: all services provided in one place, with the health and social needs of a person and his or her family being seamlessly addressed. The current “sick care” system burdens the patient and family with the complexities of coordinating care among various providers—this is a difficult process in which missed opportunities can endanger patients—for example, missing potentially dangerous drug interactions or being unaware of social barriers to adhering to treatments.

Melek presented data on the costs to employers when persons with chronic conditions experience an untreated comorbidity in mental health or substance use and the savings gained by also addressing these needs.  

Prewitt, a physician, reminded us that “all health care ends up being local.” He described Humana’s integrated care programs that have engaged consumers and have shown cost savings and better health outcomes.

Miller called on attendees to remember that multilevel problems need multilevel solutions. Currently, we train and give health providers incentives to provide fragmented care, and the community expects fragmented care. Miller challenged us to change the way we imagine care. To do this, we need to create a common language in integrated care and learn more about what works. In integrated care, “it’s not about you; it’s about we.” His call to action was the following: “Be compelling, be accurate, be timely,” pursue the Triple Aim, and “keep disrupting, keep innovating.”

The luncheon speaker, Mary Takach of the National Academy for State Health Policy, spoke about states’ experiences with integrated care and its future. When the U.S. health care system is compared with the systems in other countries, the U.S. system ranks last in quality, last in access, and highest in cost, with a high number of preventable deaths compared with rankings for other countries. Understanding that this is not sustainable or functional and that we must improve access to care and quality of care and contain costs, she called for “payment and delivery system reform.” Takach identified the patient-centered medical home model and the Medicaid health home model in the Affordable Care Act (ACA), as tools to move from a volume-based system to a value-based system. Read the rest of this entry »

Eric Coleman Named MacArthur Foundation Fellow


October 3rd, 2012

The John D. and Catherine T. MacArthur Foundation sent out its list of 2012 fellows for what some call its “genius grants” yesterday. As I looked through the list of twenty-three new fellows, I was delighted to see the name of Eric Coleman of the University of Colorado School of Medicine. He has done innovative work on improving care transitions and reducing hospital readmissions.

I am proud to say that Coleman has been a guest blogger on GrantWatch Blog!

Eric Coleman is now one of those people who “learned, through a phone call out of the blue from the [MacArthur] Foundation, that they will each receive $500,000 in no-strings-attached support over the next five years,” according to the announcement sent out by the John D. and Catherine T. MacArthur Foundation. Wow!

The foundation goes on to say that the fellowships “come without stipulations or reporting requirements and offer Fellows unprecedented freedom and opportunity to reflect, create, and explore.”

So, in case you are not familiar with Coleman’s work, he is a professor of medicine and head of the Division of Health Care Policy and Research at the University of Colorado School of Medicine in suburban Denver. He is a board-certified geriatrician.

He is perhaps best known as being the director of the Care Transitions Program, which is “aimed at improving quality and safety during times of care ‘hand-offs,’” according to his bio on the CU medical school’s website. And if that were not enough, he directs the Practice Change Leaders for Aging and Health program; read a September 27 blog post by Amy Berman about this new national program, which is cofunded by the John A. Hartford Foundation and Atlantic Philanthropies. (Berman is a senior program officer at the Hartford Foundation.) Read the rest of this entry »

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