Health Affairs, 22, no. 3 (2003): 231-237 doi: 10.1377/hlthaff.22.3.231 © 2003 by Project HOPE	New Online   New Issue: China & India   Obesity In China   Pay Cuts For Medicare Docs   Access To Care Woes

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GrantWatch

Grants & Grant Outcomes

Top International Health Care Minority Health Care Public Health State Health Policy Grant Outcomes Publications Announcements Key Personnel Changes

$1.5 million over three years. Funded by the Bill and Melinda Gates Foundation.

Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD. With this grant, the Bloomberg School’s Center for Communication Programs (CCP) is developing a serial drama, with twenty-six episodes, for Vietnamese television. Using "the principles of Entertainment-Education to weave public health messages into an entertaining storyline," the series aims to improve health in Vietnam, according to a Hopkins press release. "Audiences identify with the struggles and triumphs of memorable characters; moreover, they model their own behavior after the positive role models," Jane Bertrand, CCP director, explained in the release. The series will promote healthy behaviors and will address issues including drug abuse, HIV/AIDS, immunization, and sanitation. The CCP is partnering with VN-TV on the drama, which is expected to premiere in summer 2004. This grant also covers an evaluation "of the impact of the series," to be done by the CCP and the Hanoi School of Public Health, the release noted. The CCP also aims "to improve the capacity of Vietnamese institutions to develop and evaluate health communication programs." Anne Palmer of the CCP told Health Affairs that the project has already found and is "seeking collaborators in Vietnam," such as nongovernmental organizations, that can link their activities to the drama. This would help "to maximize the impact" of the drama’s messages. The Atlantic Philanthropies awards grants "proactively" and does not accept "unsolicited applications for funding," its Web site noted. It funds in the United States, Great Britain, Ireland, Northern Ireland, South Africa, and the Asia Pacific region. Also, "until recently, all grants were made anonymously."

$940,000 over thirty months. Funded by the Atlantic Philanthropies.

The Nuffield Trust, London, England. This grant funds an invitational conference on health care quality improvement, which is to be held in July 2003 in England. This will be the fifth in a series of meetings cosponsored by the Commonwealth Fund and Nuffield Trust and held since 1999. Expected attendees include high-level government officials, top researchers, and health care practitioners from the United States and the United Kingdom. A report on the progress of the two countries’ collaboration on quality improvement will be presented. (The two formally signed a joint statement of intent in October 2001, which initially focused on "medical error reporting and patient safety, information technology, and national reporting on quality," according to fund materials. The collaboration has since been broadened to include five other areas, including monitoring of quality of care for targeted conditions and "financial and nonfinancial incentives.") Meeting participants will explore "possible strategies" for improving quality and will hear presentations of case studies. Topics for the studies will be "patient safety and learning collaboratives in emergency room care, orthopedics and primary care," Robin Osborn of Commonwealth said.

Up to $105,000 over thirteen months. Funded by the Commonwealth Fund.

Minority Health Care

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Asian and Pacific Islander American Health Forum (APIAHF), San Francisco, CA. The APIAHF and six collaborating groups, sharing this grant, aim "to strengthen and enforce local, state and federal policies that support the provision of language access services" to all patients in California with limited English proficiency, according to a California Endowment press release. California’s Healthy Families and MediCal (Medicaid) managed care programs, for example, require health plans "to provide medical interpreter services" to all of their members with limited English, the endowment explained. It maintained that "recognition and implementation of the requirements have been sporadic at best." The grant also will be used to educate health care providers and consumers about the requirements and "strengthen collaborations" with other health advocacy groups so that a "coordinated strategy" for making progress on language access can be developed. Ernie Tai of the APIAHF commented in the release that nearly half "of the MediCal managed care and Healthy Families Program members primarily speak a language other than English." A small part of the grant is for "policy advocacy work at the national level" having a "direct impact on California," he told Health Affairs.

$959,500 over three years. Funded by the California Endowment.

National Association for Elimination of Health Disparities, Washington, DC. The grantee used this funding for a dozen community events around the nation that were to be held in early 2003 in preparation for National Minority Health Month, which was April 2003. In October 2002 the month was recognized by a congressional joint resolution as a yearly event. The month aims "to draw national attention" to health disparities that racial and ethnic minorities face and "to improve health status" among such populations, according to an Amerigroup Foundation press release. National Minority Health Month leaders and others, such as community and business leaders and members of Congress, were to attend each event, where results of a separately funded study on the health status of minority communities were to be released. The Robert Wood Johnson Foundation (RWJF) funded data collection at the ZIP code level in the twelve locations.

$60,000 over four months. Funded by the Amerigroup Foundation, "the philanthropic arm of the Amerigroup Corporation," which is a "multi-state managed health care company focused on serving people who receive health care benefits through state-sponsored programs" and is based in Virginia Beach, according to the firm’s Web site, www.amerigroupcorp.com.

University of Rochester School of Medicine and Dentistry, Rochester, NY. This funding supports a program to improve access to "needed medications" for patients in Rochester who are unable to afford them, according to Aetna Foundation materials. Project staff will assess whether these patients are eligible "for various insurance programs sponsored by New York State," including Medicaid, Child Health Plus, Family Health Plus, and the Elderly Pharmaceutical Insurance Coverage Program. If eligible, they will be helped to apply for these programs covering prescription drugs. For those in the process of applying for these state programs, those who are ineligible for them, or those who have been denied coverage by them, the project will use RxAssist, Kevin Fiscella, project director, explained to Health Affairs. This database has information for providers on how to access pharmaceutical manufacturers’ patient assistance programs and other resources yielding free or low-cost prescription drugs for those eligible. (The free, Web-based RxAssist is run by Volunteers in Health Care, an RWJF national program.)

The Aetna Foundation effort is viewed as a disparity-in-health project, according to a program officer. In 2003 the foundation’s focus is "racial and ethnic disparities in health care," its Web site said. The foundation does not accept unsolicited proposals.

$43,000 over one year. Funded by the Aetna Foundation.

Public Health

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Resources for the Future (RFF), Washington, DC. According to data cited by the RWJF, "foodborne disease is an important public health problem" in the United States and also brings high economic costs. However, the U.S. food safety system today "is fragmented...and does not allocate resources in accordance with risk," RWJF materials said. Also, "there is no agreed-upon model for ranking the public health impact of known foodborne hazards," such as salmonella. This project, directed by attorney Mike Taylor, is developing "a risk-ranking model [to] enable policymakers, risk managers, and risk analysts to compare and rank the relative public health impact of specific foodborne hazards, including appropriate measures of the economic impact" of foodborne illness, said a project "backgrounder." The Internet-based model will first focus on ranking microbial hazards and foods in combination; later it will include "chemical contaminants and intentional threats, such as bioterrorism." The grant also covers a consensus conference, planned for summer 2003, which will review and critique the model, and its eventual broad dissemination. RFF, the University of Maryland School of Medicine, and Iowa State University are collaborating on this Food Safety Research Consortium (FSRC) project. Margaret Glavin, who directs the FSRC, told Health Affairs that the FSRC has discussed the project with federal agencies with interests in its work including the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration, and the Department of Agriculture.

$346,204 over fifteen months. Funded by the Robert Wood Johnson Foundation.

State Health Policy

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Mississippi State University (MSU), Social Science Research Center, Starkville, MS. This core support is for the Mississippi Health Policy Research Center, a partnership between the Bower Foundation and the grantee. According to the mission statement of the policy center, it strives to be "a center of excellence," and its "core responsibility will be to conduct rigorous research on the [state’s] most critical health policy issues." In addition to research, the center will provide "a public forum" for informing state residents about policy issues and will maintain "a substantial library" on health policy, grantee materials stated. The center, which seeks to conduct "objective and unbiased policy analysis," has research under way, which is funded by this grant, on "the linkage between student health and academic achievement." (Labor-force studies on Mississippi physicians and studies on the "social climate of tobacco control," supported by other funders, are also in progress.) The center’s offices are at MSU and in Jackson; Art Cosby is interim director.

$1.5 million over three years. Funded by the Bower Foundation, a "conversion foundation" located in Ridgeland, Mississippi. Established in 1996, Bower funds statewide. Most of its grant making is proactive; that is, few of its grants are for unsolicited proposals.

National Academy for State Health Policy (NASHP), Center for Health Policy Development, Portland, ME. This grant is providing "logistical support and research" for the recently formed (Maine) Governor’s Office of Health Policy and Finance, which is directed by Trish Riley, and for a Health Action Team (HAT), which serves without pay, according to materials from Gov. John Baldacci’s office. His aim is "to develop a comprehensive, coordinated health system in Maine and to assure health insurance for all Maine citizens," according to a NASHP press release. His proposal will be submitted to the state legislature. The broad-based HAT, which has begun meeting, is "an advisory group of key stakeholders convened to help the governor flesh out the details of [his] plan," Riley explained to Health Affairs. HAT will get "under the hood," she added. To accept her post, Riley is on leave during 2003 from NASHP, where she has been executive director for the past fifteen years, the grantee said.

$205,849 over eleven months. Funded by the Maine Health Access Foundation.

Grant Outcomes

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"Compendium of Cultural Competence Initiatives in Health Care," a Henry J. Kaiser Family Foundation (KFF) product, "was prepared in response to the many requests from the media and others to define cultural competency and identify efforts underway in this emerging field." In table format, the compendium lists initiatives from 1990 on that were undertaken by the public and private sectors, including foundations. This concise January 2003 resource, a "first attempt," gives the reader a flavor of activities around the nation and provides definitions of terms, a list of "experts in the field," and a list of references, including many helpful Web sites. Among the challenges for this field, whether called "cultural competency or cross-cultural education," is "a misperception that [its] activities are focused exclusively on people of color," the compendium says. Activities also can focus "on diverse population groups that, for example, arise from religious affiliation, class, or sexual orientation." Also, there has been "limited research on impact and effectiveness" of this field and its activities.

The compendium is available at www.kff.org/content/2003/6067.

The National Governors Association (NGA) Bioterrorism Policy Summit, funded by the RWJF, was held in Washington in February 2003. About 150 people attended. The group included governors’ homeland security people, state health advisers, and federal officials, said an NGA press release. Forty-seven states and territories were represented. The NGA’s Center for Best Practices hosted the summit, held at an area hotel. Using "an interactive format," the high-level meeting "focused on smallpox vaccination plans, quarantine, federal/state asset coordination, the pharmaceutical stockpile, and communication with the public and media before and during a crisis." Federal and state officials had the opportunity to exchange information about bioterrorism preparedness best practices.

A summary highlighting the summit’s key points, released in March 2003, is at www.nga.org/cda/files/BIOSUMMIT03SUMMARY.pdf. For more information, send e-mail to Ann Beauchesne, abeauchesne{at}nga.org.

Public Awareness and Attitudes about Reproductive Genetic Technology was released by the Genetics and Public Policy Center, which is funded by the Pew Charitable Trusts. The center, located at Johns Hopkins University, reports on its October 2002 survey, which found that 76 percent of respondents opposed scientists trying to clone humans. Sixty-six percent of those polled approved of the "use of genetic testing during pregnancy to find out whether the baby will develop a serious genetic disease," but 74 percent of respondents disapproved of using such testing "to find out whether the baby will have desirable characteristics" such as high intelligence, according to the topline results. Most of the respondents thought that "the government should regulate the quality and safety of reproductive genetic technologies and limit human reproductive cloning," according to a press release. "The majority of Republicans, Democrats and Independents" favored "government regulation of these technologies." This telephone survey of 1,211 adults was conducted by Princeton Survey Research Associates. As decisionmakers grapple with the question of how to guide development and use of these technologies, "the options they consider must reflect society’s values and priorities," Kathy Hudson, center director, commented in the release. She added that the center will not promote particular policies; it will provide "objective, credible policy analysis and information."

For a copy of the December 2002 report, go to www.dnapolicy.org

"Seven Tools to Lowering the Business Costs of Alcohol Problems" was released by Ensuring Solutions to Alcohol Problems, a Pew Charitable Trusts–funded project. Citing numerous sources, this December 2002 issue brief describes the hidden health care costs of alcohol "problems" and other costs for employers, including job turnover. "Alcohol use on and off the job" even "causes problems" for some nondrinking coworkers, such as causing them to "redo work or cover for the drinker," the concise document says. It has suggestions for what employers can do; most are "at low to no cost." It recommends enacting "treatment-oriented workplace policies," promoting "confidential screening," and making good use of employee assistance programs. The GWU-based project also released a December 2002 report, Workplace Solutions:Treating Alcohol Problems through Employment-Based Health Insurance.

For a copy of the issue brief or the report, visit www.ensuringsolutions.org.

Speak Out for Access: The Experiences of Massachusetts Families in Obtaining Mental Health Care for Their Children was released by Health Care for All (an advocacy group) and the Parent/Professional Advocacy League (PAL). Funded by the Blue Cross Blue Shield Foundation of Massachusetts and released in November 2002, the report discusses results of a nonrandom survey of 301 families. Among the findings were that 48 percent of parents said that "their child first began to show signs of a mental health problem by age 4"; also, 48 percent said that their child’s primary care provider "never or rarely asks about mental health." One of the report’s six recommendations is in response to the above findings: "Massachusetts should pass legislation that mandates mental health screenings by age 4." PAL’s Lisa Lambert told Health Affairs in February 2003 that two state legislators had recently "filed bills for early screening for children under four."

For more details, read the report at www.ppal.net/speakout

Publications

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Exploding Myths, Finding Solutions to the World’s Health Care Crisis reports on a Salzburg Seminar, supported by the W.K. Kellogg Foundation, titled "Improving Access to Health Care and Human Services: Elements of Success." Almost seventy health professionals from around the world attended this seminar held in March 2002 in Austria. This session looked at "the state of human health [for the poor] worldwide, and reviewed encouraging models of improved health education, disease prevention, health access, and care from South America, Africa, the United States, the Caribbean, and China." Participating Salzburg Fellows also pointed out "barriers to new modes" of access and service for vulnerable people and ways to scale those hurdles. Faculty member Timothy Evans of the Rockefeller Foundation spoke on gender equity. Among the faculty speaking on "models of hope" was Ligia de Salazar, who described citizen/patient participation in health reform in Colombia. The report also includes what small groups of fellows identified as elements of an "ideal health care system" that would be broadly acceptable to diverse populations.

The sixty-four-page report is available online at www.wkkf.org/Knowledgebase/Pubs. A free hard copy can also be ordered on Kellogg’s Web site.

Paying for Choice: The Cost Implications of Health Plan Options for People on Medicare was released by the Kaiser Family Foundation in January 2003. This sixty-four-page report by Rani Snyder, Tom Rice, and Michelle Kitchman looks at how out-of-pocket costs may vary depending on beneficiary prototype, geographic market, and choice of Medigap or Medicare+Choice (M+C) plan versus no supplemental coverage. (The researchers looked at three prototype beneficiaries in eight markets.) This variation in costs "highlights the importance of these choices." One finding was that geographic area can make "a big difference in cost." The authors also state that "scope of coverage provided by supplemental insurance is often a more important determinant of total out-of-pocket costs than are premiums, but [is] often difficult for consumers to assess and compare."

The report is on the KFF Web site, www.kff.org/content/2003/6060.

A Portrait of Adolescents in America, 2001 contains results of an online survey of 2,000 teens that was conducted by the RWJF in collaboration with the Foundation for Accountability (FACCT). The aim of this survey, conducted in May 2001, was to learn about teens’ "physical, mental and social well-being and the perceptions and behaviors that promote or threaten their health." Released in late 2002, the report focuses on adolescents falling into one or more of three risk groups: "those engaging in one or more risky health behaviors [such as smoking], those with symptoms of depression and [those] with a special health care need." Researchers compared these "at risk" teens with those not in any of the groups and sought to increase understanding of "how interventions...can help teens." In the report’s conclusion, a basic goal is stated: "At a minimum, the health care system must commit to early identification and the provision of recommended preventive screening and counseling services" to young people in the risk groups.

The report is available at www.facct.org/facct/doclibFiles/documentFile_522.pdf.

2020: A Vision for Aged Care in Australia, a report containing a five-point plan for reform, was released in November 2002 by the Myer Foundation, located in Melbourne, Australia. The funder’s president, Lady Southey, AM, says in the foreword of the report that "the unique independence and connections we enjoy as a philanthropic foundation [have] enabled us to fearlessly explore new ground and bring all sectors to the discussion table." She notes that there was "remarkable consistency of opinion about the aged care services" that contributors to the project "want for Australia by 2020." (These contributors were "academics, service providers, government officials, and older consumers," according to Jean Elder, project manager.) The report’s plan suggests reforms in community care, funding, administration of care, housing, and "aged care industry planning." The two patrons (well-known people serving in an unpaid capacity) of the nine-month, approximately $600,000 (U.S.) project say that they hope that the report and several commissioned research papers on care for the elderly "will help drive policy changes for the years ahead." The foundation was established in 1959.

For a copy of the report and research papers, go to www.myerfoundation.org.au/main.asp?PageID=238.

Voices of Youth in Transition: The Experience of Aging Out of the Adolescent Public Mental Health Service System in Massachusetts—Policy Implications and Recommendations, funded by the Center for Health Care Strategies under the RWJF’s Medicaid Managed Care Program, was released in February 2003. Consumer Quality Initiatives (CQI), a nonprofit consumer research firm, completed the study. Its findings are based on qualitative interviews with twenty-four young adults who had "aged out" of adolescent public mental health services in Massachusetts; most of them were then receiving treatment in the adult system. The study describes a "fractured mental health system" in the state in which people "are forced to ‘age-out’ of a youth system between the ages of 18 and 22, losing eligibility for many, if not all, services," a press release explained. CQI recommendations for improving the situation include a "youth advocacy training curriculum for young people who have experienced the mental health system" to help them to inform policymakers "about their needs and about how the system can best respond to them," the report says. "Efforts to address the transitioning problem have been seen, however, in state government—in part because of verbal presentations made by young adults," Jon Delman, CQI executive director, explained to Health Affairs. It is his understanding, he said, that transitioning is a problem in nearly every other state.

The report is on CQI’s Web site, www.cqi-mass.org/Youth-in-Transition-Final-Report.pdf.

Announcements

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The Australian-American Health Policy Fellowships is a new program, administered by the Commonwealth Fund, which will offer "a unique opportunity for outstanding [mid-career] U.S. health policy researchers and practitioners to spend up to 10 months conducting original research and working with leading health policy experts in Australia," the fund announced on behalf of Australia’s Department of Health and Ageing, sponsor of the program. The fellowships will be "individually tailored" and will allow fellows "to gain firsthand exposure to Australian policy processes and innovative health care models and share experience on common health system challenges." Applicants must be U.S. citizens.

Applications for the 2004–2005 program, which are due 15 August 2003, and details about the program are available at www.cmwf.org/fellowships.

The Colorado Health Institute, formed in fall 2002, has received core funding from the Caring for Colorado (CFC) Foundation, Colorado Trust, and Rose Community Foundation. Together they will provide $5.7 million over five years for the institute. The funders’ joint effort "enhances the credibility, impartiality and independence" of this new institute, said the institute’s business plan. A "freestanding, independent Colorado nonprofit corporation" to be located in Denver, the institute will be a "central, reliable information clearinghouse" containing data on Colorado state and local health issues. The institute also will analyze data and disseminate its findings to key groups, including policymakers, consumers, and the media. An institute board of trustees is in place; a president is expected to be named by mid-2003. Chris Wiant of the CFC Foundation told Health Affairs of the enthusiasm that has been expressed about the institute’s potential role "in the health policy arena."

For information, call Adele Phelan, 720-320-6654.

Grand Challenges in Global Health, a $200 million Bill and Melinda Gates Foundation initiative, in partnership with the National Institutes of Health (NIH), will identify "critical scientific challenges in global health and increase research on diseases [such as malaria and AIDS] that cause millions of deaths in the developing world," according to a Gates press release. The Foundation for the National Institutes of Health will administer this initiative, which aims "to help overcome scientific roadblocks," and the NIH will "provide scientific advice, expertise, and support." Harold Varmus, former head of the NIH and now president of Memorial Sloan-Kettering Cancer Center, leads the initiative’s scientific board, which will come up with a set of "grand challenges" (or "critical problems") in global health; solutions to each challenge will be pursued. A request for applications will be issued, which "will emphasize the importance of consortia" applying, although individual scientists may apply. Competitive grants of up to $20 million will be awarded later.

Watch for more information at www.gatesfoundation.org or www.fnih.org.

Key Personnel Changes

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The Commonwealth Fund’s board has selected Sam Thier to be its new chairman. Thier, a physician, is professor of medicine and of health care policy at Harvard Medical School and is the former president and chief executive officer of Partners HealthCare System. Among his past positions was president of the Institute of Medicine. Thier succeeds Charlie Sanders as the fund’s chairman.

Healthcare Georgia Foundation, located in Atlanta, announced that it has appointed Martha Katz its director of health policy. The foundation "was created in 1999 with an endowment from Blue Cross and Blue Shield of Georgia," a press release explained. Katz is a former deputy director of policy and legislation at the CDC.

The Robert Wood Johnson Foundation has named John Lumpkin its new senior vice-president and director of its health care group, according to a 31 March 2003 press release. Prior to joining the RWJF staff, Lumpkin, a physician, was director of the Illinois Department of Public Health; he had held that position since 1991.

The Kaiser Family Foundation named Gary Claxton a vice-president and director of its Health Care Marketplace Project. He is based in the funder’s Washington, D.C., office.

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