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GrantWatch

Grants & Grant Outcomes

$750,000 over two years. Funded by the Pew Charitable Trusts.

Health Professions Training

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New York University (NYU), New York, NY A team from NYU’s Robert F. Wagner Graduate School of Public Service and the nursing division of its School of Education revised and implemented the Helene Fuld Health Trust’s "leadership development program for emerging nurse leaders," according to a March 2001 press release. Twenty associate and baccalaureate nursing students from across the nation were chosen to participate as fellows in this intensive program, which has three main goals: "developing individual capacity for leadership; strengthening understanding of broader health care systems, including financing financing and innovative roles for nursing; and providing a foundation for understanding the effects of public policy on health care delivery and nursing practice." Jina Paik, the trust’s grants manager, said that the fellowship does not consist of scholarship money but is an all-expense-paid, year-long program for students "interested in pursuing leadership positions outside the clinical arena."

$287,890 over one year. Funded by the Helene Fuld Health Trust.

Information Dissemination

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National Health Law Program (NHeLP) Inc., Los Angeles, CA. These funders are supporting "the creation of an engaging, consumer- friendly Web site...to help the public overcome problems commonly encountered with health insurance coverage," according to Pew Charitable Trusts materials. Consumers will be able to learn their options and rights under various types of public and private health plans and "how to exercise them" so that their "health care needs are met." Features will include responses to frequently asked questions, suggested questions for consumers to ask their plan’s representative if a coverage issue arises, and contact information for help with problem resolution. Sample letters and links to Web sites of "helpful organizations and relevant federal or state agencies" will also be included, Pew’s materials said. Larry Lavin, director of NHeLP, told Health Affairs that NHeLP plans "to conduct a fair amount of market research" to determine what "the public would like to know and how best to present it" and will provide links to insurance companies for detailed information on plans. The site launch is planned for early 2002. Meanwhile, NHELP seeks additional funding.

$490,000 over two years. Funded by the Pew Charitable Trusts.

$50,000 over one year. Funded by the Open Society Institute.

Mental Health Care

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Alliant University Foundation, San Diego, CA. This funding supports Project ESSEA (Ethiopia, Somalia, Sudan, and Eritrea in Africa),which aims "to address the behavioral health needs of East African refugees and immigrants" in San Diego County, according to an Alliance Healthcare Foundation press release. Having "experienced violence, torture, persecution and the loss of family and friends" in their unstable countries before they came to the United States, these persons are "at greater risk for behavioral and emotional problems." As its mission is "to build an effective and culturally competent behavioral health service system" for persons from these East African nations, Project ESSEA not only is providing prevention and intervention services but also is helping to build "the capacity of public and private mental health facilities and their staffs to provide appropriate mental health services." Various groups are collaborating on this effort. The project has hired and trained outreach workers, an Alliance spokesperson said. "The initial response to the program has been overwhelming," she commented. Within its first month, some forty clients were referred to the program.

$603,464 over three years. Funded by the California Endowment.

$250,000 over two years. Funded by the Alliance Healthcare Foundation.

$471,000 over four years. Funded by the Robert Wood Johnson Foundation (RWJF).

Central Clinic, Cincinnati, OH. Working with other groups, the grantee aims "to create, implement and evaluate common policies and procedures for people with co-occurring substance abuse and mental health disorders across multiple systems in Hamilton County," Ohio, according to a Health Foundation of Greater Cincinnati press release. A so-called no-wrong-door philosophy will be used that allows such persons "to be directed to appropriate treatment from any agency with which they come into contact."

$207,700 over eighteen months. Funded by the Health Foundation of Greater Cincinnati.

Special Opportunity in Mental Health Funding Request for Proposals (RFP). Having received 378 applications, the California Endowment chose forty-six projects to receive grants under this RFP to improve access to and quality of mental health programs across California. The grants aim to "enable community-based organizations to develop new prevention and intervention approaches, targeting the most at risk, vulnerable populations," according to a foundation press release. The RFP was issued in response to information contained in "recent studies, including the Little Hoover Commission’s Report, which contends that the mental health system in California is broken, and is in desperate need of reform." After evaluating all of the applications, the endowment developed recommendations for the mental health community at large, including state agencies, policymakers, and others on how to improve the state’s system. These include "increasing the level of resources available to mental health providers, and providing them with the funding flexibility to think creatively about program approaches." Mary Rainwater of the endowment said in an e-mail interview with Health Affairs, "We hope to be able to learn from our grantees" about best practices "that can and should be replicated and supported... either through the legislature or the [California] Department of Mental Health or both."

Approximately $24 million total in forty-six grants of two or three years’ duration. Funded by the California Endowment.

Minority Health

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Center for the Advancement of Health (CAH), Washington, DC. The CAH was awarded this grant to establish and coordinate the Kellogg Minority Scholars in Health Disparities program. Out of this funding, six such scholars have each been awarded up to $50,000 a year for two years. They will use the grants to study "health disparities by race, ethnicity, gender and socioeconomic status," according to an April 2001 press release from the CAH, a nonprofit group. The fellowships are for persons holding a doctorate "in fields related to the study of determinants of health." The fellows, who also receive fringe benefits and coverage of certain expenses, will look at the causes of disparities "and consider policy solutions." They will do research at either Harvard University’s Center for Society and Health; Morgan State University’s Center for Urban Health Assessment, Evaluation, and Policy Research; or the University of Michigan’s Institute for Social Research. Barbara Krimgold, director of the program (now in its pilot phase), said in the release, "There is a dramatic need for minority scientists and policy makers not only to be represented but to take leadership roles in promoting good health and in developing health and social policy solutions for the 21st century for our increasingly diverse population."

$1.5 million over two years. Funded by the W.K. Kellogg Foundation.

Outcomes And Quality

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National Committee for Quality Assurance (NCQA), Washington, DC. Funded by this grant, the NCQA is identifying "patients’ priorities for information on physician quality" and figuring out the best way to communicate such information to consumers, according to Commonwealth Fund materials. The project team, directed by Gregory Pawlson, also will "lay the groundwork for a set of physician quality measurements similar to those currently in use for managed care plans." Specifically, the NCQA will work on adapting its existing Health Plan Employer Data and Information Set (HEDIS) measures for use at the individual physician or physician-group level. The grantee will also determine if HEDIS measures can be combined into composite measures of physician quality, Pawlson told Health Affairs. In addition, the NCQA will grapple with methodological issues. "From the earliest stages" of this effort, the NCQA is involving "all major players in the quality arena," fund materials said. Karen Davis, Commonwealth Fund president, noted in a press release, "For the first time, we are asking patients what’s important for them to know about their doctors—and how they will use that information."

Up to $296,583 over twenty-one months. Funded by the Commonwealth Fund.

Substance Abuse Prevention

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University of California, San Francisco. The grantee is using the American Legacy Foundation’s grant "to establish permanent internet access to tens of millions of pages of once-secret tobacco industry documents," according to a Legacy press release. Access will be through a library, which will contain materials from six companies and Legacy-funded publications and is directed by Karen Butter. This archive will help to solve tobacco control researchers’ current problems in consistently gaining access to industry documents. In addition, Legacy’s grant funds development of "a center for scholarly study of the material," which will also train tobacco control scholars and the wider public health community. The two programs thus aim to improve Internet access to "industry and related documents," to periodically add to the online collection so that it totals around forty million pages, and to make sure that the collection "remains fully accessible to scholars, health advocates, journalists and the public." The RWJF grant funded computer equipment and programmers. The National Cancer Institute is providing partial funding for "library infrastructure," Stanton Glantz, who oversees the entire two-prong project, said in a telephone interview.

$15 million for the library and the research center. This includes $10 million for an endowment, $2.5 million in start-up funding over five years, and $2.5 million for capital costs. Funded by the American Legacy Foundation.

$500,000 over one year. Funded by the Robert Wood Johnson Foundation.

Outcomes Of Grants

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The California Wellness Foundation 2000 Annual Report, released in March 2001, discusses several outcomes of policy work conducted by its grantee, the California Center for Health Improvement (CCHI). "One of its biggest successes has been in the area of tobacco use," the report points out. "Since 1996, the center has devoted much of its energy to documenting public opinion and analyzing tobacco policies, including a [state] ban on cigarette vending machines, designated nonsmoking areas and the cigarette tax." Since then, "a sea change has occurred" in the way that the public and policymakers view tobacco. The foundation notes that "California is ranked as...one of the most effective states in reducing tobacco use." While conceding that "major change always results from the combined efforts of many key players," the funder says that the CCHI "was at the forefront of the conversation and provided a steady source of data and bipartisan analysis."

The annual report is available on the foundation’s Web site, <www.tcwf.org>, or by calling 818-593-6600.

The Commonwealth Fund includes a report on "The Fund’s Performance as a Grantmaker, 1992–99," by fund official John Craig Jr., in its latest annual report. Craig enumerates lessons learned in five areas—communications, foundation staffing, strategy, grant-making procedures, and surveys and related research. Among the lessons are that "generating information for public policy can be a strong suit for a foundation of the Fund’s size, provided its leadership and key grantees have the requisite expertise, experience, and intellectual creativity." The foundation also learned that "commissions, task forces, and national programs...have been highly successful," such as its Program on Medicare’s Future, which "has had a major impact on Medicare policy" through Marilyn Moon’s efforts, he says. Although surveys have yielded "new, timely, and important information," Craig says that a challenge "is the public’s growing unwillingness to participate in telephone surveys." He notes that "low response rates can make survey findings unacceptable to major professional journals."

The annual report, released in February 2001, is available on the foundation’s Web site, <www.cmwf.org>, or by calling toll-free 888-777-2744.

Demand Treatment!, which receives major funding from the RWJF, held its first leadership institute in March 2001. An initiative of Join Together ("a national resource for communities fighting substance abuse and preventing gun violence") and based at Boston University, Demand Treatment! aims to increase the number of persons receiving brief interventions and "quality treatment" for alcohol and drug abuse in U.S. communities, according to the Join Together Web site. Physician participants said in follow-up interviews for a Join Together Online article that "education, training, and infrastructure development would go a long way towards getting doctors to screen their patients for addiction and to advocate for treatment and recovery." Also, doctors would be roused "from their current apathy" by better reimbursement rates for providing treatment. Sixteen Demand Treatment! local partners, chosen in February 2001, plan to "take direct action against the discrimination and other barriers that prevent 3 million people a year from getting treatment that could help them recover, "a press release explained. For example, the Des Moines partner is implementing a media campaign and plans to advocate for passage of "state legislation providing equal health insurance coverage for [substance abuse] treatment." Numerous organizations and several federal government agencies are cosponsors of Demand Treatment!

The article is available online, <www.jointogether.org/sa/wire/features> (see item dated 26 April 2001).

Drug Abuse: Evaluation of Legal and Treatment Alternatives (DELTA) Project Report, released by Howard County, Maryland, and the Horizon Foundation, resulted in County Executive James Robey’s announcing that he would take eight steps, in response to the report, "immediately." These steps include creating and staffing a special Substance Abuse Strategies Unit "to coordinate and implement authorized recommendations from the report," according to a January 2001 press release. Horizon is funding the unit. The county is in the process of hiring someone to coordinate the unit, county spokesperson Vicky Gates told Health Affairs. The 100-page report assesses how Howard County’s "prevention, treatment and criminal justice systems" approach substance abuse and recommends reforms. The mission of Horizon, a public charity that resulted from the merger of Johns Hopkins Medicine and Howard County General Hospital, is "enhancing the health and wellness" of Howard County residents.

The report’s executive summary is available online,<www.co.ho.md.us>. For a copy of the full report, call the county’s public information office, 410-313-2022.

Grantmakers In Health (GIH) held its annual meeting, "Collaborating for Change: Exploring Health Partnerships That Work," 28 February–2 March 2001 in San Diego. John Moran Jr. of the Colorado Trust opened the meeting with rousing words for funders —that the uninsured in America were hardly mentioned in the 2000 election. He also noted the existing disparities in care. GIH should inspire policymakers to meet the needs of the medically underserved, and mental health care should be given parity, Moran said. GIH’s Lauren LeRoy noted that there were some 60 percent more registrants for this funders’ meeting than there were in 2000. Responding to a question from the RWJF’s Paul Jellinek, plenary speaker David Satcher, surgeon general of the United States, said that foundations can be more independent and flexible than a federal government agency, which has to worry about Congress’s approval of its budget. "Mental Health: New Opportunities for Collaboration" was the topic of a roundtable. Howard Goldman of the 246 University of Maryland School of Medicine suggested that foundations fund "programs designed to address the problem of stigma and discrimination" and efforts to reduce financial disincentives for persons with mental illness to get treatment. Conference funders included the Alliance Healthcare, Archstone, California HealthCare, California Wellness, HMSA, and Kansas Health Foundations, the RWJF, and Queens Care.

For more information, call GIH, 202-452-8331.

A media campaign in El Paso County, Texas, to raise awareness about the State Children’s Health Insurance Program (SCHIP) and how to enroll children seems to have been effective, Ann Pauli, president of the Paso del Norte Health Foundation, told Health Affairs. The foundation awarded a contract in the summer of 2000 to an advertising agency "to develop a media piece that was culturally relevant and included a Spanish version and [to] get the message out during hours that young parents were watching television and listening to the radio." The Paso del Norte–funded campaign ended in fall 2000, but then the state asked to use the foundation’s media piece along the whole U.S.- Mexico border, and the state is paying for the air time. Paso del Norte agreed. Using information from the West Texas CHIP Collaborative, on 16 April 2001 Pauli said that the county had enrolled "an estimated 72 percent" of kids there who were eligible for SCHIP. "It appears that we [El Paso County] have the highest percent of enrolled" in the state, she added. (In spring 2000 enrollment in the county had been lagging.) She noted that as of April 2001, the state was still running the commercials daily.

For more information, send e-mail to Ann Pauli at <apauli{at}pdnhf.org>.

Results of a survey on U.S. adults’ attitudes about illegal drugs and drug policies were released in March 2001. The survey was conducted by the Pew Research Center for the People and the Press, an independent opinion research group, which is sponsored by the Pew Charitable Trusts. According to the February 2001 survey, 74 percent of respondents agreed with the statement, "We are losing the drug war"; 74 percent also agreed that "we will never be able to stop drugs from coming into this country because the demand...is so high." Over the years there has been a shift away from agreement that interdiction efforts by the U.S. government are "very effective" (52 percent in this 2001poll versus 66 percent of respondents in a 1988 ABC News poll). In 2001 only "a slim majority" said that "in general, drug abuse should be treated as a disease rather than as a crime," the survey report says. Seventy-three percent of respondents supported allowing physicians "to prescribe marijuana for their patients."

The report is available online, <www.people-press.org/drugs01rpt.htm>.

Secretary-General of the United Nations (UN) Kofi Annan was a keynote speaker at the Council On Foundations (COF) annual conference in Philadelphia. Introduced by Tim Wirth, president of the United Nations Foundation, Annan reminded the large crowd of foundation staffers and trustees at the 30 April 2001 luncheon that "governments can no longer tackle global challenges on their own." He said that "only through effective global partnerships...can we mount an effective response" to human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS)—"the world’s biggest public health crisis." To attain five objectives that Annan mentioned, including prevention and putting "care and treatment within everyone’s reach," he said several things are needed: for example, "stronger public health care systems in developing countries" and "a great deal of new money." Specifically, "we need to be able to spend an additional $7 to $10 billion a year" for all aspects of the HIV/AIDS struggle, "over an extended period of time." He proposed a global fund dedicated to battling "HIV/AIDS and other infectious diseases" that can get money where needed, quickly. Governments, taxpayers, corporations (including pharmaceutical companies), foundations, and others would play a role. Annan urged foundations "to increase and multiply" their contributions —financial and intellectual—to the fight against AIDS. Foundations have flexibility, moral authority, and "expertise on the issues." He added, "You can and do contribute actively to policy discussions, and to decisions about the kind of research that is worth investing in." He said that he hoped that delegates to a June 2001 UN meeting on HIV/AIDS "will be ready to agree on a global strategy...and will have firm commitments" for financing it.

Annan’s speech is available on the Web at <www.unorg/News>. Click "In Focus/Fighting AIDS" and look for the item dated 30 April 2001.

"Strengthening the Nursing Workforce: A Showcase of Strategies," a forum organized by George Mason University’s (GMU’s) Center for Health Policy, Research, and Ethics, was sponsored by the W.K. Kellogg Foundation and the Friends of the Division of Nursing (of the Health Resources and Services Administration) in affiliation with the American Association of Colleges of Nursing. The March 2001 forum, held in a U.S. Senate meeting room, attracted almost 300 persons, including legislative aides and nursing school deans, a GMU press release reported. First term Sen. Tim Hutchinson (R-AR) said in the release, "We’ve got to have a national campaign" to attract young persons to nursing. He said that he planned to introduce a bill that would set up a federally sponsored nurse corps and provide funds for nursing education. (He and Sen. Barbara Mikulski [D-MD] introduced the Nursing Employment and Education Act 5 April 2001.) Forum speakers who followed showcased four federally funded "model programs to help the nation fill the nursing pipeline," the release said.

More information is available at this Web site <chpre.gmu.edu>, or by calling EileenO’Grady, 703-993-1931, at GMU in Fairfax, Virginia.

Publications

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Eliminating the Medicaid Asset Test for Families: A Review of State Experiences is a sixty-four-page "background paper" financed by the Kaiser Commission on Medicaid and the Uninsured, part of the Henry J.Kaiser Family Foundation (KFF). The April 2001 publication looks at the experiences of the nine states and the District of Columbia that had, as of 31 July 2000, removed the Medicaid resource, or asset, test (one of the five Medicaid eligibility requirements) for "parents of low-income children." This well written study by Vernon K. Smith and colleagues is based on "structured" telephone interviews in early 2001 with state Medicaid officials. One interesting finding was that generally "an asset test actually kept few families from meeting Medicaid eligibility requirements." The study notes that officials. One interesting finding was that generally "an asset test actually kept few families from meeting Medicaid eligibility requirements." The study notes that officials from these ten jurisdictions "unanimously agreed" that eliminating the asset test for parents "has been successful." For example, it has enabled states to "streamline the eligibility determination process" and "make the enrollment process for families friendlier and more accessible." The paper also includes "options available to states to raise asset limits or eliminate the asset test altogether for adults in families applying for Medicaid."

"Medicaid Spending Growth Remained Modest in 1998 but Likely Headed Upward" is a February 2001 Urban Institute paper for the Kaiser commission. Authors Brian Bruen and John Holahan find that in fiscal year 1998 "enrollment declined and expenditures grew more slowly than historical rates for the third consecutive year." From their analysis they conclude, though, that Medicaid spending growth rates "in the 10 percent range could easily occur in the near future."

Both papers are on the KFF’s Web site, <www.kff.org>. A free copy of each is also available from Kaiser’s publication request line, 800-656-4533. Ask for package code 2239 (asset test) or 2230 (spending growth).

Announcement

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The Blue Cross and Blue Shield of North Carolina (BCBSNC) Foundation, located in Chapel Hill, was launched in November 2000.The foundation’s funding interests include programs that "increase access to health care for needy and underserved populations" and that improve the health of children, adolescents, the elderly, and minorities, according to a fact sheet. Programs must "primarily benefit North Carolinians." The foundation’s first grant was a four-year, $1 million award for ECU CARE, a program at East Carolina University’s Brody School of Medicine. That program offers "real health care solutions for those uninsured patients with the most limited financial and social resources and complex medical needs," a press release noted. Most of this funder’s grants will not be that size, however, a spokesperson explained.

For details, visit this Web site, <www.bcbsnc.com/foundation/foundation.html>, or call 919-765-4114.

Key Personnel Changes

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The Bill and Melinda Gates Foundation named Sylvia Mathews to be executive vice president. She most recently had been deputy director of the U.S. Office of Management and Budget (OMB) in the Clinton administration.

The Robert Wood Johnson Foundation’s senior vice-president, Ruby Hearn, retired at the end of April 2001 after twenty-five years at the foundation. Also, among the new members of the RWJF’s board of trustees is Robert Wood Johnson IV, chairman and chief executive officer of the Johnson Company Inc. and the New York Jets football team.

The John D. and Catherine T. MacArthur Foundation named Julia Stasch vice president of its Program on Human and Community Development. Mental health is among several grant-making areas for which she is now responsible. Stasch most recently had been chief of staff for Chicago Mayor Richard M. Daley.

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