This Year's Highlights
The New York State Diabetes Campaign: Reversing the Epidemic
In June 2008, NYSHealth unveiled a landmark $35 million campaign to reverse the growing diabetes epidemic in New York State. “The New York State Diabetes Campaign: Reversing the Epidemic” is working to improve clinical care, mobilize communities, and promote policy.
The Campaign works with statewide associations that represent three types of primary care providers in New York State to improve outcomes for patients with diabetes: community health centers, individual private practices, and hospital outpatient departments. Initial grants were made to the Community Health Care Association of New York State, the New York State Academy of Family Physicians, the New York Chapter of the American College of Physicians. Partnering with community- and faith-based organizations, the Campaign will strengthen community capacity to implement and expand diabetes screening and management, and increase access to diabetes prevention and management resources. As part of the Campaign, NYSHealth established a Diabetes Policy Center that conducts and funds policy analysis and advocacy to support private and public payment policies that sustain a comprehensive, coordinated care system for patients with diabetes. In partnership with Bridges to Excellence, the Policy Center is working to align incentive payments among the majority of payers in the State to encourage primary care physicians to increase the quality of care they deliver to patients with diabetes. The Policy Center also is pursuing policies that expand access to diabetes services, including self-management education and support.
Initiative to Integrate Care for Co-Occurring Disorders
In 2008, NYSHealth identified co-occurring mental health and substance use conditions as a major health problem, and partnered with the New York State Office of Mental Health and the New York State Office of Alcohol and Substance Abuse Services to strive to eliminate the barriers to mental health and substance use treatment services. NYSHealth’s initiative—which now comprises its third priority area—aims to achieve the integration of mental health and substance use services for patients at all of New York’s 1,223 licensed mental health and substance abuse outpatient treatment centers.
After an intensive selection process, NYSHealth awarded $3.2 million to National Development and Research Institutes, Inc. to create the first statewide Center of Excellence for the Integration of Care (CEIC) to transform the system of care for 1.4 million New Yorkers suffering from both mental health and substance use conditions. The grant directly benefits patients, and works to address the enormous costs in lost productivity, re-hospitalization, and related health care costs that are burdening the State’s health care system.
NYSHealth as a Convener of Stakeholders, Policymakers, and State and National Leaders
Since its inception, NYSHealth has capitalized on the expertise of New York’s health leaders by convening and moderating discussions among stakeholders, policymakers, and State and national leaders on how best to tackle public health challenges. In November 2008, NYSHealth hosted its first statewide conference, “Reforming New York’s Individual Health Insurance Market,” in New York City. With more than 250 attendees, the conference examined the structure of New York’s individual insurance market, presented new research by the United Hospital Fund on the implications of merging the individual, small-group, and Healthy NY markets, and contrasted reform proposals from two of the largest insurers in New York State.
With support from NYSHealth, the Rockefeller Institute hosted an April 2008 meeting between NYSHealth Coverage Consortium members, senior officials from the Executive Chamber and Departments of Health and Insurance, and other stakeholders to share preliminary findings. Also with Foundation support, the Manhattan Institute convened two public conferences focusing on market-based reforms and the United Hospital Fund has convened several briefings.
In August 2008, the Foundation held the second installment of its “A Conversation With…” series with Dr. Christina Economos, Tufts University professor, to discuss the findings of her three-year trial on childhood obesity, “Shape Up Somerville: Eat Smart. Play Hard.” The series’ format provides an intimate discussion with health experts, and features an interview with a special guest and NYSHealth President and CEO James R. Knickman.
Freelancers Union’s Entrepreneurial Health Insurance Model
With layoffs on Wall Street and the corporate sector putting health insurance front and center in the national debate, NYSHealth joined a group of leading philanthropies and businesses—along with the Freelancers Union — to pioneer an entrepreneurial model for providing health insurance to independent workers. The Foundation contributed to a pool of $16 million to launch Freelancers Insurance Company, Inc. (FIC), which offers affordable and flexible health insurance plans for eligible independent workers.
As a freestanding insurance company, FIC enables members to select from five customized health insurance plans approved by the New York State Department of Insurance. Unique from commercial insurance carriers, FIC’s core concept is to cross-subsidize the plans—if one plan fails to earn a profit, it will not be routinely dropped. Instead, the proceeds from another of the program’s plans will make up the shortfall. FIC offerings are currently limited to eligible independent workers in the New York metropolitan area. However, Freelancers Union offers health insurance to independent workers in 30 additional states through Golden Rule, and dental insurance in all 50 states through The Guardian Life Insurance Company of America. Freelancers Union is identifying additional states in which it may launch the FIC model.
The Foundation’s Enhanced Communications
2008 marked a significant year for NYSHealth to broaden its communication efforts and establish its presence in New York State’s public health forum. With the launch of the NYSHealth Web site in January 2008 and the publication of its first two annual reports (2006-07 and 2007-08), the Foundation was able to showcase both its own initiatives and the innovative projects of its grantees.
Additionally, the Foundation found its voice in the media with hits from Brooklyn to Buffalo. In 2008, State and national newspapers, journals, and magazines published more than 50 feature stories about the Foundation or its grantees, and five opinion editorials and 11 letters to the editor by President and CEO James R. Knickman. NYSHealth held its first three press events, and was featured in eight broadcast media segments. Visit the NYSHealth News and Events pages for a sampling of these stories.
NYSHealth Coverage Consortium
The NYSHealth Coverage Consortium emerged as a leading new source of information and analysis on the issue of the uninsured. Consortium members work collaboratively to study health care coverage trends, assess coverage expansion proposals, and develop recommendations to expand public and private coverage in New York State. Its assessments include projections on costs, coverage, and consequences of each of the options, providing an invaluable asset for policymakers.
In 2008, more than 15 analytic products were produced by NYSHealth grantees. For example, Columbia University was the first to compare leading coverage expansion proposals on the basis of the number of people who would gain coverage; drop private coverage in favor of public options; and how each plan would increase statewide health care spending, including the cost to State government to finance expansions. Cornell University explored the opinions of New York State residents and employers on health care reform options. The United Hospital Fund modeled the effects of merging three segments of New York State’s commercial health insurance market: Direct Pay, Healthy New York, and Small Group. The Rockefeller Institute of Government assessed statewide strategies for improving private health insurance coverage to small groups and examined rating policies, group purchasing arrangements, premium subsidies, refundable credits, and reinsurance as strategies for increasing access to private health insurance.
Make the Road’s Healthy Homes Initiative
The severity of the asthma epidemic in Bushwick is indisputable with 15% of four- and five-year-old Bushwick children suffering from the illness and overall asthma rates hovering well above the national average. With the support of an NYSHealth grant, Make the Road New York has helped nearly 200 people fight asthma, and its efforts are bearing fruit. Nearly 70% of the 180 Bushwick residents participating in the program have reported an improvement in their conditions.
This short-form video features NYSHealth grantee Make the Road New York’s Healthy Homes Initiative, which is combating the asthma epidemic in Bushwick, Brooklyn through an innovative four-pronged approach to: 1. Address poor housing conditions 2. Provide legal assistance 3. Increase access to health care 4. Conduct community outreach The success of Make the Road’s project was also featured in a Daily News article, “Bushwick’s Asthmas Sufferers Learn How to Help Themselves.”
Providing Evaluation Technical Assistance for NYSHealth Grantees
NYSHealth implemented a program of technical assistance for its grantees to train them in evaluation techniques. Led by the Center for Health Care Strategies, a team of evaluation professionals is providing one-on-one intensive assistance to some of our grantees to teach them how to determine if, how, and for whom their projects are having their desired outcomes. The training includes the use of logic models, establishing measurable outcomes, collecting and analyzing data, and communicating project findings.
In addition, NYSHealth is conducting daylong workshops on evaluation for our grantees in various parts of the State. The workshops enable grantees to strengthen their evaluation capabilities, and to network with and learn from fellow organizations. NYSHealth’s commitment to evaluation reflects its desire to be an accountable organization that achieves tangible impact, as well as our move into providing “beyond the check” activities that enhance our grantmaking.
Initiative for Returning Veterans and their Families
As a component of NYSHealth’s priority to Integrate Services for People with Co-Occurring Mental Health and Substance Use disorders, the Foundation identified returning Iraq and Afghanistan war veterans and their families as a high-need, population who have unmet reintegration needs, including health, mental health, and social service needs.
National data show that one in three Iraq veterans will face serious psychological injury including depression, Post Traumatic Stress Disorder, or anxiety. Returning veterans who do not receive timely and appropriate care for mental health issues are at risk for chronic mental illness, substance use issues, divorce, unemployment, homelessness, and even suicide. With thousands of returning Iraq and Afghanistan war veterans in New York State, NYSHealth is playing a catalytic role in ensuring that veterans and their families receive the comprehensive reintegration services they deserve. NYSHealth kicked off the $2 million NYSHealth Initiative for Returning Veterans and Their Families at an April 2008 press event in Rochester. The Initiative—which includes a first-of-its-kind statewide assessment of broad reintegration needs—focuses on the health, mental health and substance use issues experienced by returning veterans and their families because they are important public health issues requiring immediate attention and targeted resources in communities throughout New York State.
Refinement of the Special Projects Fund
While most of NYSHealth’s grantmaking focuses on three priority areas—expanding health insurance coverage, improving the management and prevention of diabetes, and integrating substance use and mental health services—in 2007, the Foundation recognized it could be an important resource by being responsive to opportunities that fit our mission, but are outside our three priority areas, and launched its Special Opportunities Initiative.
In 2008, the Foundation began to refine the initiative, changed the name to Special Projects Fund, and launched two requests for proposals (RFPs) that resulted in several million dollars to innovative programs throughout the State. One RFP specifically sought proposals to build or expand service-delivery capacity, and the other RFP requested proposals with potential large-scale impact on the health care system. The criteria for applicants are spelled out in the respective calls for proposals, found in the Apply for Funding section of the NYSHealth Web site. Typically, the criteria emphasize time-sensitive opportunities, the likelihood of project sustainability, and strong potential for replication elsewhere in the State.