This Year's Highlights
Growing Community Health Centers
Community health centers are on the front lines of primary care, but many community health centers struggle with low margins, limited funding, and growing demand. After health reform is implemented fully, community health centers are expected to double capacity to serve 3 million New Yorkers.
In 2012, NYSHealth’s investments supported two approaches to ensure that New York’s community health centers have the resources, capacity, and facilities needed to succeed.
The Foundation made 10 grants in April 2012 and six grants in December 2012 to community health centers in nine medically underserved regions to enable them to serve more patients, open new sites, or add new services. Grant projects included helping a children’s clinic take on adult patients; funding an architect to design a new medical center from an empty lot; and adding dental services in a region that was almost completely lacking oral health care.
NYSHealth also supported a technical assistance project with the Community Health Care Association of New York State (CHCANYS) to help health centers successfully apply for Federal grants to create or grow community health center sites. When the grants were announced in June 2012, 11 of the 12 centers the NYSHealth grant had assisted won awards potentially worth more than $25 million—a 64-fold return on the Foundation’s investment. A GrantWatch article by NYSHealth staff in the November 2012 issue of Health Affairs examined the strategy behind this initiative.
Spreading Effective Diabetes Prevention Programs
With more than 4 million New Yorkers at risk for developing diabetes, spreading promising prevention programs has been a cornerstone of the NYSHealth Diabetes Campaign. NYSHealth and the Alliance of New York State YMCAs have worked to replicate the national Diabetes Prevention Program (DPP) in 10 regions of the State. The DPP has been shown to reduce the risk of adults with prediabetes from developing the disease by more than 50%. An October 2012 NYSHealth conference explored additional opportunities to spread the DPP throughout the State. Also in 2012, NYSHealth released several papers that examine key facts about the DPP; the evidence to date for the DPP; and the progress and results of the program’s implementation in New York State. In an NYSHealth video below, New Yorkers discuss the impact the DPP has had on their health and lives.
Another Campaign partner, the Institute for Leadership (IFL), has led the replication of Defy Diabetes, a six-week diabetes detection and prevention program in places of worship. As IFL begins to wrap up its Faith Fights Diabetes initiative, it has trained more than 250 community health workers to offer this program in 160 faith-based organizations across the State. The programs have served more than 2,400 people, almost two-thirds of whom are at risk of developing diabetes and reside in low-income neighborhoods.
Achieving Integrated Care for Mental Health and Substance Use
Since 2008, the Foundation has made a strategic investment to increase the number of providers capable of screening, diagnosing, and treating both substance use and mental health disorders simultaneously. More than 60% of New Yorkers with a claim for a substance use disorder also have a psychiatric disorder, while more than 50% with schizophrenia also have a diagnosis of a substance use disorder. To advance this area, NYSHealth established the Center for Excellence in Integrated Care (CEIC). At the end of 2012, after a five-year investment, NYSHealth had successfully achieved its goals in this area. CEIC met its target of working with 600 of the 1,000 licensed mental health and substance use programs across the State to help them make the necessary changes to address people’s mental health and substance use problems at the same time. Early evaluation results of the initiative show that these sites are now offering integrated care for people with co-occurring mental health and substance use disorders.
Moving Forward in Veterans’ Health
In February 2012, Colonel (Ret.) James McDonough, Jr., U.S. Army, past Executive Director of the New York State Division of Veterans’ Affairs and past Chief Executive Officer of the Veterans Outreach Center (VOC), joined the Foundation as its first Senior Fellow for Veterans Affairs. One of Col. McDonough’s early tasks has been to oversee efforts to replicate statewide the promising VOC model outlined in the NYSHealth-funded publication, “Coming Home to Caring Communities: A Blueprint for Serving Veterans & Families,” to help organizations build capacity and provide greater access to services. His efforts in 2012 to build support in New York State and nationally to meet the health care, mental health, and social service needs of veterans and their families included convening discussions on suicide prevention efforts in the military and effective community-based services for veterans and their families, as well as authoring a New York Times “At War” blog on making the transition from soldier to veteran.
Under Col. McDonough’s leadership, the Foundation awarded a grant to Syracuse University’s Institute for Veterans and Military Families as part of an initiative to support veteran-serving organizations and leverage Federal resources. The project offers free technical assistance to community-based organizations to help them prepare successful applications to receive Federal funding through the U.S. Department of Veterans Affairs’ $300 million Supportive Services for Veteran Families program.
Designing the Front End of Health Insurance Exchanges
As health reform moves ahead and states prepare to get health insurance exchanges up and running for 2014, a simple, user-friendly way for consumers to understand and navigate the exchanges will be key to helping millions enroll nationwide. To meet this challenge, NYSHealth partnered with eight of the nation’s top health funders to collaboratively support Enroll UX 2014, a design for a state-of-the-art online tool to assist consumers with identifying eligibility, selecting a plan, and enrolling in health insurance. This project set out to design what the front end of health insurance exchanges would be (that is, what a typical consumer will use and experience when shopping for and buying coverage on the exchange).
NYSHealth’s participation in this project allowed it to leverage its funds alongside those of other leading funders, including the California HealthCare Foundation, Colorado Health Foundation, Atlantic Philanthropies, and the Robert Wood Johnson Foundation. This partnership enabled NYSHealth to play a national leadership role in helping to develop a product based on an understanding of the needs and behaviors of all potential users. As a result, New York State has formally announced that it will use the Enroll UX prototype as the front end of its exchange.
Supporting Innovative Projects
NYSHealth’s Special Projects Fund (SPF) continues to support unique projects that are consistent with the Foundation’s mission to improve the health of all New Yorkers, especially the most vulnerable, but fall outside the Foundation’s priority areas. In 2012, NYSHealth awarded more than $2 million in SPF funds to support a diverse set of initiatives across the State, including projects that help low-income and elderly consumers understand and navigate the health system; improve access to health care in service areas with acute shortages; support and strengthen safety net providers to reach more people; and address statewide health system issues that could improve the efficiency or effectiveness of the system.
Three highlights of the 2012 SPF grants are:
Girls Educational & Mentoring Services, to train medical professionals in emergency departments to identify youth who are victims of commercial sex exploitation, and to connect them with agencies that can support their exit and recovery from the commercial sex industry.
New York Lawyers for the Public Interest, to protect the long-term health of schoolchildren and school personnel by working with community boards, grassroots advocacy groups, and parents to improve clean ups at contaminated school sites.
Rochester General Hospital, to replicate a successful health care model that increases refugees’ access to high-quality primary care services in a cost-effective and financially sustainable manner.
The Foundation is accepting inquiries for 2013 SPF grants through April 19, 2013. View the application instructions and Request for Proposals.
Unveiling New Website Design and Public Scorecard
In March 2012, NYSHealth launched a newly designed version of its website. The Foundation has grown and matured—both as a grantmaker and as a valued source of trusted, reliable information and resources—since its inception in 2006, and the new website design sought to reflect these changes. With its fresh look and improved functionality, the new website is designed to better highlight the work of NYSHealth grantees; make it easier for users to find NYSHealth publications, data, and other resources; and more clearly communicate the Foundation’s goals and strategies, as well as funding opportunities and how to apply for grants.
The new website design also allowed the Foundation to launch online its organizational scorecard, a series of indicators and targets to track its performance related to program impact, customer service, reputational capital, and organizational capital. The scorecard allows the Foundation to track its effectiveness and impact in its efforts to improve the health of all New Yorkers. Though scorecards have taken hold in philanthropy as a tool for assessing overall organizational performance, few foundations share them publicly. NYSHealth is pleased to make its scorecard publicly available.
Integrating Care for Dual Eligibles
More than 700,000 people in New York are simultaneously enrolled in both Medicare and Medicaid. These dual eligibles are among the State’s costliest and most complex Medicaid beneficiaries. NYSHealth has undertaken a number of projects to inform, shape, and improve policies that will affect the health of these patients. A February 2012 NYSHealth-funded report, “Integrating Care for Dual Eligibles in New York: Issues and Options,” developed by Mathematica Policy Research, provided a comprehensive profile on:
- Dual eligible characteristics, care needs, costs, and service delivery options.
- Aspects of New York’s Medicaid program that present opportunities and challenges for integrated care programs for dual eligibles.
- Integrated care program design options based on a review of programs in other states, the characteristics and care needs of dual eligibles in New York State, and feasible options based on State capabilities and potential for Federal approval.
The report offered specific recommendations for New York State as it works to improve the coordination and integration of care for dual eligibles. The NYSHealth report has been credited as the blueprint for New York State’s subsequent proposal on dual eligibles to the Centers for Medicare & Medicaid Services, which incorporated nearly all of the report’s recommendations.
Convening Key Stakeholders
In addition to making grants, NYSHealth plays a leading role in fostering discussions among grantees; community partners; national, State, and local officials; health care advocates; and other key stakeholders across New York State, holding dozens of conferences, webinars, and other events each year. In 2012, the Foundation hosted five meetings of its “A Conversation With…” series. This series, moderated by NYSHealth President and CEO James R. Knickman and other NYSHealth staff, brings together leaders in the field to discuss issues pertinent to the Foundation’s work. This year’s conversations included:
“What the Supreme Court Could Do to Health Reform: A Conversation with Abbe Gluck.” Professor Gluck laid out the elements of the Affordable Care Act and the four key questions that the Court would consider.
“National Diabetes Prevention Program: A Conversation with Kenneth Thorpe.” Dr. Thorpe discussed the national Diabetes Prevention Program, a model that has been shown to reduce the risk of developing diabetes by more than 50% in adults with prediabetes.
“Healthy Children, Toxic Schools: A Conversation with New York Lawyers for the Public Interest.” Attorneys Dawn Philip and Christina Giorgio discussed how New York City regulations, public disclosure procedures, and insufficient oversight have created environmental hazards within the City’s public schools.
“Implementing Health Reform Post-SCOTUS: A Conversation on Consumer Engagement Strategies.” State officials and consumer representatives highlighted key opportunities to educate and engage individuals and small business owners about what the Affordable Care Act will mean for them.
“Suicide Prevention in the Military: A Conversation with Jacqueline Garrick and Dr. Yvette Branson.”Jacqueline Garrick, Director, Defense Suicide Prevention Office at the Pentagon, and Dr. Yvette Branson, Suicide Prevention Coordinator, VA NY Harbor Healthcare System, discussed rising suicide rates among active military service members and recent veterans.
Advancing Primary Care
In 2013, NYSHealth is adding a new priority area focused on Advancing Primary Care. In this new area, the Foundation will focus on three strategies: (1) expanding primary care access and capacity; (2) encouraging new approaches to primary care delivery for high-need populations; and (3) advancing payment reform. In 2012, the Foundation convened health care leaders from across the State to help inform these strategies; our Community Advisory Committee, Board, grantees, and other experts identified key needs and opportunities to advance primary care in New York State.
In addition, the Foundation awarded several grants in 2012 that lay the groundwork for the advancing primary care priority area. A project with Refuah Health Center supports delivery and payment reform approaches to improve patient care and reduce costs. Another project, through a grant to THINC, supports the design and development of a shared data platform that will enhance the work of a regional Comprehensive Primary Care (CPC) initiative in the Hudson Valley/Capital District. The CPC is a Federal demonstration program designed to foster collaboration between public and private health care payers to promote more effective and cost-effective primary care delivery.
Other projects focused on primary care delivery and payment reform in 2012 include grants awarded to the Institute for Family Health and the Adirondack Health Institute.