Health Affairs, 27, no. 5 (2008): 1464-1466 doi: 10.1377/hlthaff.27.5.1464 © 2008 by Project HOPE	New Online   McAllen, TX & Beyond: An Expert Roundtable   Geography & Reform   Medicaid or Insurance Exchange?   Siren Song of New GME   Public Plan Option: Pro & Con

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GrantWatch

EDITOR’S NOTE: Some parts of the GrantWatch section are published on the Web only. The online-only material usually includes selected coverage of both recently announced grants and publications about or funded by foundations. (Reporting of selected grant outcomes and key personnel changes at foundations, as well as GrantWatch essays, reports, and interviews, are published in both print and online form.)

Online GrantWatch material is posted twice a month. Click here to sign up to receive an e-mail alert when new content is posted.

GrantWatch is funded in part by the Robert Wood Johnson Foundation.

Election 2008

“Kaiser Health Tracking Poll: Election 2008,” Henry J. Kaiser Family Foundation (KFF), October 2008, 19 pp., http://www.kff.org/kaiserpolls/h08_posr102108pkg.cfm (click on “Key Findings”). This document contains results of the KFF’s final poll in this pre-election series, which began in March 2007. The goals for the series were to “track changes in the saliency of health as a political and policy priority, what the public’s priorities are for a health reform plan, and whether any candidates are breaking through with the public with their health reform plans,” the KFF Web site explains. In the October 2008 poll, health care came in third, behind the U.S. economy and Iraq, when registered voters were asked, “Thinking ahead to the November 2008 presidential election, what is the single most important issue in your vote for president?” Among various health care issues, “making health care and health insurance more affordable” was cited by 50 percent of registered voters as the “most important.”

Sixty-two percent of registered voters polled in October 2008 said that “given the economic challenges” facing the United States, “it is more important than ever to take on health care reform”; only 34 percent said that considering those challenges, “we cannot take on health care reform right now.” As might have been expected, there is a partisan gap on this topic: 75 percent of Democrats are in favor of taking on reform now, compared with only 42 percent of Republicans sharing that view; registered Independents were in the middle at 61 percent.

“2008 Presidential Candidates: Health Care Issues Side-by-Side,” KFF (with the assistance of Health Policy Alternatives)http://www.health08.org/healthissues_sidebyside.cfm. This part of the KFF’s health08.org Web site “focuses on important health care issues not necessarily addressed in the candidates’ health care reform proposals.” For example, one can compare positions of John McCain and Barack Obama on such topics as long-term care; Medicaid and the State Children’s Health Insurance Program (SCHIP); medical malpractice; and mental health parity. The KFF notes that the “campaigns were given the opportunity to review and comment on the content” of this Web page. Check out this useful interactive tool in the days before the election. It has been “constantly updated,” according to a KFF spokesperson.

Related resources:

Opinion pieces:

“The Candidates’ Health Plans,” Editorial, New York Times, 28 October 2008, http://www.nytimes.com/2008/10/28/opinion/28tue1.html?_r=1&oref=slogin. According to the editorial, “both candidates have largely accepted the prevailing expert wisdom on ways to improve quality and lower health care costs over the long run.” However, it says that McCain and Obama “have very different ideas on the best way to make insurance available and affordable for all Americans.” Having said that and pointed out the pros and cons of the plans, the Times seems to favor the Obama plan. Numerous comments on this piece were posted.

“Health Care Reform in the Next Administration,” Meagan Murray of Public Agenda, 23 October 2008, http://www.publicagenda.org/pages/health-care-reform-next-administration. In this article Murray reports on a Maxwell School/Public Agenda Policy Breakfast event in October 2008 that featured Drew Altman, president and chief executive officer (CEO) of the KFF. Paraphrasing Altman, she says, “No matter who wins on November 4th, there’s one thing for sure: neither the health care reform plan advocated by Barack Obama, nor that favored by John McCain, is going to be enacted as is.” The Maxwell School of Citizenship and Public Affairs is at Syracuse University. Public Agenda is “a nonprofit, nonpartisan organization,” according to its Web site.

“Questions and Answers about Obama’s Health Plan,” Michael D. Tanner of the Cato Institute, op-ed distributed by McClatchy News Service, 22 October 2008, http://www.cato.org/pub_display.php?pub_id=9742. Tanner says that “the devil is in the details” of Barack Obama’s plan, so he points them out.

Read the candidates’ latest health plans:

“Barack Obama and Joe Biden’s Plan,” http://www.barackobama.com/issues/healthcare/ (accessed 29 October 2008).

“The Truth about the McCain-Palin Health Care Plan,” http://www.johnmccain.com/Informing/Issues/19ba2f1c-c03f-4ac2-8cd5-5cf2edb527cf.htm (accessed 29 October 2008).

Flu Shots and Voting

“Convenience Is Key to Adult Flu Vaccinations: Vote & Vax Clinics across the United States Will Increase Flu Vaccination Rates,” Vote & Vax press release, 15 October 2008, http://www.rwjf.org/vulnerablepopulations/product.jsp?id=35693. Read in the release about Vote & Vax flu shot clinics, which “will be talking place at or near polling sites, including some early voting locations.” Vote & Vax, a collaborative project of the Robert Wood Johnson Foundation (RWJF) and RWJF grantee Sickness Prevention Achieved through Regional Collaboration (SPARC), is “an innovative nonpartisan, nonpolitical national public health strategy.” The RWJF awarded almost $750,000 for the 2008 Vote & Vax initiative. Doug Shenson, SPARC executive director, provided an update to Health Affairs on how the project is going, as of 28 October 2008. At that point, 250 clinics in 36 states were planned. He commented in the release that “increasing the number of people . . . who are able to conveniently receive an influenza vaccination is a proven way to protect the health of thousands of people in this country.” The numbers of clinics and states participating in the project have markedly increased since 2006. To see if there is a clinic near you, click here. (An FAQ page on the Vote & Vax Web site notes that the shots are not free; “public health providers are asked to charge for influenza vaccinations as they would at their other community flu shot clinics.”) For the latest information, go to http://voteandvax.com/Newsroom.aspx. Shenson wrote a Perspective on SPARC, located in Lakeville, Connecticut, for Health Affairs’ July/August 2006 thematic issue on public health.

Foundation News

Sierra Health Foundation Adds a Public Policy and Education Program

Chet Hewitt, president and CEO of Sierra Health Foundation since August 2007, told Health Affairs’ GrantWatch about some recent changes at the foundation, which is located in Sacramento, California, and funds in twenty-six counties in northeastern California. He reminded us that “in recent years,” Sierra Health’s “primary funding interests have included organizational capacity building, health leadership training, youth development, and children’s dental health,” as well as a “successful conference and convening program and [the foundation’s] camp for special-needs children in Plumas County,” California. Most of these efforts continue, according to the funder’s Web site. Hewitt said that since he started at the foundation, he has “had an opportunity to get to know many of the communities, institutions, and people” in its funding region. Hewitt has tried to increase his “understanding of the challenges and opportunities facing the region, and the roles Sierra Health could play in promoting regional health and well-being.” This listening he has done is “important work,” he commented. The aim is to “build upon the good work done [by Sierra Health] before,” as the foundation continually improves “the quality and impact” of its work.

In late 2007 Sierra Health’s board of directors “updated and refined the foundation’s mission, vision, and values” to reflect its “quest to be both a catalyst and partner” in efforts to improve regional health and well-being. Hewitt commented, “We know that our region is changing socially, demographically, and culturally.”

So what is new at Sierra Health? In June 2008 the funder launched its Responsive Grants Program, which will award $2 million over 2008–2009 “to support projects in three broad funding areas: Expanding Health Insurance, Improving Health Care Access, and Promoting Health.” To make sure that “rural communities are adequately represented,” Sierra Health has set aside at least 30 percent of the $2 million for projects in rural areas, Hewitt said.

In addition, Sierra Health has “implemented a Public Policy and Education Program” to capture and disseminate “lessons learned” from its grantees, “and to promote better-informed policy discourse in related areas,” he said. One of Sierra Health’s initial “partners” (grantees with which it is collaborating) for this policy work is the WIND homeless youth center, which is working “to develop a youth-focused personal electronic health record [EHR]” system so that “homeless and emancipated foster youth” will have permanent health records. Diane Littlefield, senior program officer, has primary responsibility for the Public Policy and Education program, in addition to other responsibilities.

For more information, visit Sierra Health’s Web site.

Global Health

Viewpoint from Rwanda on how the economy is affecting philanthropy:

The economic crisis is “also having a great effect on philanthropies and poor countries,” according to a 20 October 2008 e-alert received by Health Affairs’ GrantWatch section. The public relations firm sending the alert mentioned Josh Ruxin, founder and director of the Access Project in Rwanda, “which is devoted to strengthening the healthcare structure and improving the lives of Rwanda’s citizens.” (Ruxin is also an assistant clinical professor of public health at Columbia University’s Mailman School of Public Health.) The alert said that “Ruxin has already felt the impact of the [economic] crisis on the non-profit world”; specifically, “he has had several major donors delay huge donations for health center construction in Rwanda.”

GrantWatch contacted Ruxin via e-mail to pursue this subject further. We asked him to focus on private philanthropy. From his perspective as a project director seeking funding for global health and economic development efforts, he said, “Private funders today are seriously ratcheting back their giving in the hopes that the financial markets will improve.” He said, “Even in cases where there were serious agreements, all bets are off when private foundations and donors lose 40–60% of their wealth and ability to give in such a short timeframe.” What advice would he impart to others? “The lesson for grantees is simple: you can never be too diversified in your donor base.”

He said that during the last market downturn he saw that “there were many small family foundations [that] held single stocks,” and in 2001–2002, they “saw their values plummet—in many cases by more than 90 percent.” The lesson there, he said, is that “small, emerging foundations [have] to be very careful to diversify their portfolios.” That economic downturn “pushed” him “to advance projects that were structured much like the for-profit sector.” This is because results over the past several years have shown him “that private-sector donors and investors seek out projects that are configured like the business world, not like traditional charity projects.”

In answer to another question from GrantWatch, Ruxin remarked, “I do believe that if the downturn results in the end of some projects that have been of negligible or no benefit, that’s a good thing.” He commented, “Many projects exist solely to pay [for] salaries, business class [airline] tickets, and useless reports” and said that these kinds of things have been chronicled by Easterly and others. “The downside of the downturn, of course, is that plenty of superb projects will not even have the chance to make their case for funding in the next year, and that’s a shame.” However, the best such projects—those that “dignify the poor and show rock-solid management—should be able” to come out of this crisis as “more efficient and more effective” projects, he added.

According to the Access Project’s Web site, “Poor health is both a cause and an effect of extreme poverty; sickness and disease are key factors keeping families, communities, and nations mired in destitution.”