Colorado Funders Take Wait-and-See Approach to Recreational Marijuana

April 21st, 2014
by Christie McElhinney

On April 10, the 100th day since legal sales of recreational marijuana began in Colorado, Colorado’s Attorney General John Suthers told funders gathered at the mid-year meeting of Philanthropy Southwest, held in Denver, that foundations need to pay attention to the “fallout” over the legalization of marijuana as this will be a “huge issue in America over the next several years.”

Suthers, who described himself as an inherently optimistic guy, said he’s pretty pessimistic about the outlook in Colorado because of the widespread availability of marijuana. The success or failure of this experiment should be judged by three measures, he said—the rate of youth drug use, the impact of marijuana use on school performance, and the impact on criminal organizations.

Use of marijuana by youth is already increasing markedly, said the attorney general. While youth use of alcohol, tobacco, and marijuana have decreased in the United States over the past ten years, he noted that recent studies have found one in eight Colorado youth smoked marijuana twenty or more times in a month, putting marijuana use by Colorado youth markedly above the national average.

Most people think smoking pot is pretty harmless, said Suthers. Not so for youth, he said, noting that heavy marijuana use before age eighteen can lead to a permanent loss of IQ, along with an increased opportunity for mental health problems. As well, Suthers said that 20–25 percent of those who regularly use marijuana before age eighteen will become drug addicts, compared with 4–5 percent of users over age twenty-one.

While Colorado funders have been meeting to discuss ways to help diminish harmful effects of marijuana, they are following the state’s lead on health- and safety-related efforts said panelist Bill Fowler, senior vice president, Grants Program, for the Daniels Fund. Most important, right now, said Fowler, is education. He said the Daniels Fund is interested in developing a messaging campaign to help adults understand how to talk with young people about marijuana, how to store edible pot products safely out of reach of children, and what is and isn’t legal. Read the rest of this entry »

Nominee for HHS Secretary Has Had High-Level Jobs at Two Foundations

April 15th, 2014
by Lee-Lee Prina

On Friday, following President Obama’s announcement of health and human services (HHS) secretary Kathleen Sebelius’s resignation, he nominated Sylvia Mathews Burwell as her replacement.

Now director of the Office of Management and Budget (OMB) for the Obama administration, Burwell is no stranger to philanthropy as the New York Times and the Chronicle of Philanthropy’s Philanthropy Today blog reported this past week.

President Obama mentioned Burwell’s work at the Bill and Melinda Gates Foundation, where she was chief operating officer and later president for global development. She then was head of the Walmart Foundation, he added.

Read more about Burwell and her background in my April 1, 2013, GrantWatch Blog “People Post” at the time she was nominated for the OMB post—about a year ago!


Adding Their Voices: What Older Adults Are Saying about Team Care and the Medical Home

April 14th, 2014
by Marcus Escobedo

Foundations, government, and the health care sector are making large investments to reengineer and revitalize primary care, hoping this will improve the cost and quality of health care overall. Primary care practices that use expanded teams to deliver well-coordinated care designed around the needs of patients and families—widely known as patient-centered medical homes—have become the base of this movement.

For these investments to be successful, we at the John A. Hartford Foundation think it is important to target our efforts where these care innovations can reap benefits large enough to make a meaningful difference. The older adult population, with complex needs and higher costs than younger people have, represents the biggest orchard of low-hanging fruit out there. That is why we continue to invest in testing and spreading models of primary care for older adults that incorporate geriatrics expertise. However, we also think we can do as much as we want to and for this (or any) population, but without their input and involvement, we will fail.

To begin incorporating the input of older adults into the current debate about medical homes, we recently released our latest public opinion poll, “On Your Team.” We asked adults age sixty-five and over about their experiences with the expanded team and enhanced services offered through this type of primary care. This survey of 1,107 older adults was conducted January 30 through February 3, 2014, by PerryUndem Research/Communication using Knowledge Network’s nationally representative online panel.

Given the mixed results of medical home studies thus far (supported by many of our colleagues in philanthropy such as the Commonwealth Fund), we think this survey adds to our understanding of this evolving model’s potential benefits and points to the areas of greatest importance to the older patients we are trying to serve.

Through this poll, we heard an important message. Contrary to stereotypes that older adults distrust and resist changes to their health care and don’t trust anyone but their own physician, older adults value team care and other medical home services. Older adults want access to care when they need it (for example, same-day appointments, twenty-four-hour telephone access), coordination between their primary and specialty care providers, and a primary care team (including nurses, social workers, mental health providers, and others) all working off of a plan of care based on the individual patient’s own health goals.

While relatively few older adults receive this type of team care (just 27 percent), an overwhelming majority (83 percent) of those who do receive it report that it has made a difference in improving their health. Even among the many respondents who don’t receive team care now, a substantial majority (73 percent) say they would like to. Also, 61 percent say they believe this type of care would improve their health. About half (48 percent) of respondents who do not currently receive team care say they would change providers if it meant they could get such care. And as the number of medical home services that people received increased, so did their reported level of satisfaction with their care. Read the rest of this entry »

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