Here are a few interesting items that recently came across my desk.

Funding For NIH    

“An Open Letter to Congress,” Guy McKhann of the Zanvyl Krieger Mind/Brain Institute at Johns Hopkins University, in the Dana Foundation’s Brain in the News, April 2017.  McKhann notes that President Donald Trump’s budget proposal includes an 18.2 percent cut in the National Institutes of Health’s (NIH’s) budget. He says, “If we do not come up with methods of either slowing the progression of [Alzheimer’s] disease or returning a person [with it] toward more normal cognitive function, this one disease group could break any health plan that can be devised.” And dementing illnesses are costly. Although “substantial progress” has been made in understanding Alzheimer’s, we don’t have the medications or procedures—resulting from this “newfound knowledge”—to change the course of the disease. Now is not the time to provide a disincentive to researchers by cutting NIH’s funding, McKhann comments.

Oral Health

“What’s Keeping State Oral Health Leaders Up at Night?” by Stacey Chazin and June Glover of the Center for Health Care Strategies, March 27. The authors highlight the key issues addressed at the “launch meeting” for the first cohort of participants in the center’s State Oral Health Leadership Institute, which is funded by the DentaQuest Foundation. The institute “provides leadership coaching and technical assistance to support collaboration between [five] pairs of Medicaid dental program directors and state oral health program directors.” One issue raised was the need to understand how changes to the Affordable Care Act could affect oral health. Participants also said that social determinants of oral health (such as access to healthy foods) should be considered. Participants also discussed opioid abuse resulting from treatment of dental-related pain—states are interested in oral health prescribing guidelines as they seek to address this crisis.

Bold Health Philanthropy

“In Philanthropy, Let’s Bring Back the Boldness That Saved My Life,” by Laura Landy of the Fannie E. Rippel Foundation, March 27. This post drew me in with its engaging title and intro about Landy’s walk in the woods with her dogs, when all of a sudden, she “took a fateful step,” which resulted in a dislocated foot. She maintains, “Were it not for my cell phone and the Robert Wood Johnson Foundation (RWJF), I likely would never have been found in those remote woods—at least not in time.” So what does the RWJF have to do with this? Well, back in the 1970s, the RWJF dedicated itself to funding work in thirty-two states “to build out” a local emergency medical response network. “The strategy was to invest in radios, training, cross-agency coordination, and a central phone number: 9-1-1,” Landy explains.

She says that although foundations are now running many experiments “at the edges of [health system] transformation, . . . few dare to disrupt the status quo and the prevailing market structures.” She comments that “foundations are among those best positioned to ask” the tough and “increasingly critical questions” that will lead to new ideas. The Rippel Foundation, which she leads, aims to “challenge the status quo” and invest in health “systems change,” she notes. Its flagship initiative is called ReThink Health, which also receives funding from the RWJF.

Health Reform

“What It Means to ‘Act Now,’” by Carolyn Wang Kong of the Blue Shield of California Foundation (BSCF), February 15. The author writes that when she joined the foundation, in early 2016, she was encouraged by the fact that health insurance coverage in California was reaching its highest levels and “care transformation and innovation” were gaining traction. These were “fueled by the successful implementation of the Affordable Care Act (ACA).” But she “never could have imagined that” in early 2017 “we would be facing the uncertainty that confronts us today.” Kong describes the foundation’s decision, made “because of the unknown challenges ahead,” to support its Act Now Fund with $1.32 million. Staff decided to determine what the BSCF’s critical priorities are “and let go” of what was not on that list. That might mean working with new partners, or with old partners in new ways, and that was OK. Staff would act faster, but not with thoughtlessness or short cuts. Among the urgent priorities was to defend “the gains that have been made” from expanding access to Medi-Cal (California Medicaid). This change from BSCF’s traditional grant-making approach was difficult at times, she says, but staff at the foundation learned about its partners’ “needs, realities, and capacity.” They also “were reminded about what matters most—the health, safety, and wellbeing of all Californians,” Kong remarks.