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10 -Y E A R R E P O R T 20 0 6 –2016
10 -Y E A R R E P O R T 20 0 6–2016
(NYSHealth) is a private, state-
wide foundation dedicated to improving the health of all New Yorkers, especially the most vulnerable. Today, we concentrate our work in two strategic priority areas: building healthy communities and empowering health care consumers. We also engage in responsive grantmaking through a special projects fund and maintain a special interest in veterans’ health.
CONTENTS Chairwoman’s Message
10 Years of Making Grants
The Foundation is committed to creating change by making grants, informing health care policy and practice, spreading effective programs to improve the health system, serving as a convener of health leaders across
the State, and providing technical assistance to its grantees and partners.
The Top 10
10 Years of Informing Policy
10 Years of Sharing What Works
As the organization matured and experienced changes over time—establishing itself as a leader on public health and health care issues in New York, identifying and sharpening its priority areas, transitioning from the leadership of founding CEO Jim Knickman to David Sandman—its central mission endured: improving the health of all New Yorkers, especially the most vulnerable. The Foundation cares about making sure that New Yorkers can stay healthy, and that they can get the care they need and deserve when they do get sick. That is a pretty simple idea, but turning that aspiration into a reality is challenging, especially given the complexities of our health care and public health systems and the diversity of our State. My Board colleagues and I are incredibly proud of the work the Foundation has done to get us closer to that reality, such as: helping the State to implement health reform effectively and get millions of New Yorkers enrolled into health insurance coverage; working in communities to ensure that residents have access to affordable healthy foods and opportunities for safe physical activity; empowering consumers to make the health care system work better for them and their families; and helping hundreds of thousands of New Yorkers avoid complications from diabetes. More work lies ahead. The Foundation has ambitious goals, and large-scale change takes time. The Board is thrilled to be working with a talented staff that is dedicated to making a meaningful difference in the lives of all New Yorkers.
As we mark NYSHealth’s 10th anniversary, the staff and I have considered what we have learned and accomplished in our first decade and the important work that lies ahead. This report is organized by three approaches we use to create impact: making grants, informing policy, and sharing what works. Many of our successes result from a combination of these strategies; we achieve more when we deploy a range of tools to achieve our goals. To ensure the effective implementation of the Affordable Care Act in New York State, for example, we made a range of grants for policy analysis, widely disseminated and communicated those findings and implications to policymakers and other leaders, and learned from and shared what we knew from the experience of other states like Massachusetts.
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Using all of our capital, not just our financial resources, is what it takes for NYSHealth to be more than just a grantmaker—to be a changemaker. Our dollars are relatively small. Our $15 million annual budget is modest compared to the more than $200 billion New York State spends each year on health care.
MESSAGE FROM THE PRESIDENT AND CEO
To make meaningful change, we need to maximize our human and reputational capital, as well as our financial capital. We have built a knowledgeable and committed staff that works with grantees and partners to tackle the public health and health care issues facing New York State. We have prided ourselves on being a convener that can bring together diverse stakeholders to tackle common problems and forge consensus. Moving forward, as a more established organization, we may expend some of our earned capital by taking more activist stances on policies and practices that could improve New Yorkers’ health. I feel privileged and honored to lead the organization into our second decade. I look forward to working with all of our grantees and partners to advance our shared mission.
MESSAGE FROM THE CHAIR
On behalf of all of the past and current Directors of the New York State Health Foundation, I am pleased to mark the organization’s 10th anniversary. Before I joined the Board last year, I had been a grantee, so I have been keenly attuned to the Foundation’s work throughout its first 10 years.
Ellen Rautenberg, Chair, NYSHealth Board of Directors
David Sandman, Ph.D., President and CEO
Our grantmaking strategies have evolved to stay current with and anticipate shifts in the health and health care landscape, both nationally and statewide. Adaptability has also allowed us to strategically build on prior investments as we shape and pursue our priority areas. And by striking a balance between adopting clearly defined goals and being flexible and responsive to community needs, we’ve been able to invest in some long-term initiatives while also having the freedom to back new and innovative projects.
Our signature program in this area supports six communities across the State: Clinton County; Brownsville, Brooklyn; North End, Niagara Falls; East Harlem; Near Westside, Syracuse; and Two Bridges, Lower East Side. In each of these neighborhoods, diverse groups of community leaders are coming together to increase residents’ access to healthy, affordable food and expand opportunities for safe places to exercise and be active. Ultimately, our goal is that these community-level changes will lead to improvements in neighborhood residents’ consumption of healthy foods and rates of physical activity.
Over the years, our staff has spent time in communities and regions across the State—meeting with current or prospective grantees and staying on top of important health trends and concerns in New York. This in turn has helped inform our grantmaking and allows us to stay connected to and build strong relationships with our grantees.
Less than two years into the program, we’ve already started seeing exciting changes in the six neighborhoods. For example, in Clinton County, we helped build a new walking trail as part of a resident-driven, community-supported strategy to increase opportunities for physical activity. The Rouses Point Trail, a walking path that connects the local civic center, recreation center, and Lake Champlain, was completed in July 2016. Residents
Here are some of our grantmaking highlights over the past 10 years, along with some lessons learned from working with our grantees and other partners.
OVER THE LAST
In the Near Westside neighborhood of Syracuse, we worked to address community members’ top concern and barrier to physical activity—neighborhood safety. We took a comprehensive approach to addressing the social and environmental determinants of health by working with the Lerner Center for Public Health Promotion to conduct a needs assessment of the community and renovate the neighborhood’s centrally located Skiddy Park. We also worked with local partners to secure the relocation of a police station to the park. Now
HAS AWARDED MORE THAN $117 MILLION TO MORE THAN 400 GRANTEE ORGANIZATIONS TO IMPROVE THE HEALTH OF ALL NEW YORKERS.
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Since we began operations in 2006, the Foundation has awarded more than 700 grants totaling more than $117 million to more than 400 organizations. As the only statewide health foundation in New York, we’ve supported a wide range of grantees across all regions of the State: from the eastern tip of Long Island to Western New York to the urban epicenter of New York City to the rural reaches of the North Country. With an annual grants and operations budget of approximately $15 million, we have worked over the last 10 years to use our resources effectively and efficiently. What are the particular health or health care issues that affect many people and
eagerly started using the trail as soon as the asphalt was dry, and our grantee, Clinton County Health Department (CCHD), has further plans to install benches and activity stations to reach both older adults and youth. CCHD has also been working to increase the number of locally grown fruits and vegetables served in schools, leveraging a grant from the New York State Department of Health. It is coordinating with cafeteria directors and school food professionals to increase schools’ focus on using local produce to make school meals more nutritious while making families and the community aware of these efforts. For example, Clinton County is an area with many large apple orchards, yet the majority of apples served in schools used to come all the way from Washington State. Now local schools are starting to serve more locally grown apples.
10 YEARS OF MAKING GRANTS
BUILDING HEALTHY COMMUNITIES In 2015, we launched our work to build healthy communities, emphasizing community-level interventions that make it easier for New Yorkers to lead active, healthy lives and eat healthy, nutritious, and delicious food.
must be addressed? Can we make a difference in a specific area? Are we the right organization to take on this work? We’ve used these questions to guide us and make sure we’re going after the right goals and able to have the most impact.
“We’re trying to bring the kids back to the park and make it so people know that it’s a safe place. We’re trying to bring back the good of the [Near] Westside instead of the bad.” Timari Brunson, Skiddy Park summer camp counselor
the community has banded together to revitalize Skiddy Park as a safe and fun place for residents of the Near Westside. As another part of our work in Syracuse, the Lerner Center has partnered with a local supermarket to implement a nutrition scoring system to help residents make informed, healthy food choices. The system was launched February 2016 and rolled out aisle by aisle to collect meaningful data and feedback along the way. In Brownsville, Brooklyn, our work with the Brownsville Partnership (BP) continues to improve access to healthy, affordable food in the neighborhood. In addition to partnering with GrowNYC to coordinate the Brownsville Youthmarket (a neighborhood farmers market operated by local youth through the GrowNYC program), BP also provides technical assistance to another local food organization, Project EATS, which operates several urban farms and farm stands in Brownsville with a goal to improve local food systems. Through this partnership, Youthmarket employees are also now working on the local Project EATS farms—connecting the youth to how the food is grown and ulti-
Foundation begins operations
James R. Knickman appointed as first President and CEO.
mately making them both better salespeople and advocates for eating fresh produce. In response to community requests, BP is partnering with a local community activist and farmer to sponsor its own version of a fresh food bag program, where residents pay $15 a week to receive a bag of fresh produce. As of August 2016, 20 Brownsville families have signed up for this program. The community activist/farmer also works with Project EATS to do cooking demonstrations at its weekly farm stands. Finally, BP assisted in the development and planting of a new community garden at the Brownsville House New York City Housing Authority campus, in collaboration with the Mayor’s Office of Criminal Justice and youth from Green City Force. EXTENDING HEALTH CARE COVERAGE TO THOSE MOST IN NEED Health reform opened up game-changing opportunities for us to help get more uninsured New Yorkers health care coverage—a core part of our mission from the very beginning. The passage of the Affordable Care Act (ACA) in 2010 provided an unprecedented opportunity to take coverage expansion to new heights. In partnership with numerous grantees and allies, we made it a key
Foundation hires first staff members and moves into its first location on Eighth Avenue.
priority to help New York State prepare for effective implementation of health reform. We immediately focused on policy work and technical assistance on topics such as the Health Benefit Exchange, Navigator and Consumer Assistance Programs, the Basic Health Plan option (see page 18), risk adjustment, the development of a website design for the NY State of Health Marketplace, an analysis of the gaps in New York’s health information technology systems related to Medicaid eligibility and enrollment, and the development of a “Roadmap” that reviewed provisions of the ACA as they affect New York State.
workers; immigrants; and lesbian, gay, bisexual, and transgender individuals. Overall, more than 2.8 million people have received coverage through the NY State of Health Marketplace.
As open enrollment approached in October 2013, NYSHealth pivoted to focus on engagement strategies that would help previously uninsured New Yorkers understand their insurance options and enroll in coverage. Direct assistance and faceto-face support would be necessary to make this possible, so we launched a statewide Enrollment Network of trusted community-based organizations. The Enrollment Network has directly enrolled tens of thousands of New Yorkers in coverage, with a particular emphasis on those known to be disproportionately uninsured: low-wage
Although the State’s health coverage expansion has been a success, some New Yorkers are still left behind, including the estimated 400,000 undocumented and uninsured immigrants who are ineligible for coverage under the ACA. An important grant in this area supported an advertising and public education campaign with the New York City Mayor’s Office of Immigrant Affairs to increase awareness of potential State-funded Medicaid eligibility among Deferred Action for Childhood Arrivals (DACA) recipients and potential applicants. This campaign—the largest
The Berger Commission releases recommendations to reform hospitals and nursing homes across New York State.
First Request for Proposals issued.
First round of grants totaling $5.7 million awarded to 23 grantees.
National health expenditures top $2 trillion for the first time.
New York City Board of Health unanimously votes to approve regulations for calorie-labeling on menus by chain restaurants— the first U.S. city to do so.
A Brooklyn resident who worked every day of the week at two part-time jobs, Jerome went uninsured for years and couldn’t afford to miss a day of work if he got sick or needed to see a doctor. After seeking help from one of our Enrollment Network grantees, Jerome was deemed eligible for Medicaid and was able to finally get coverage. “Having health insurance means the world to me,” said Jerome. “I get to check up on myself and make sure I’m good health-wise.”
“The recognition allowed us to clearly assess and validate our performance. It has strengthened the commitment of Montefiore physicians to deliver superior diabetes care. We are striving to maintain and improve this performance and hope to ultimately see reductions in rates of kidney disease, heart attack, and stroke.” Rohit Bhalla, M.D., formerly of Montefiore Medical Center
effort in the United States to date—reached tens of thousands of Medicaid-eligible immigrants and millions of New Yorkers with more than 2,000 ads in almost all City subway lines. The campaign also trained more than 120 immigrantserving attorneys and enrollment navigators and counselors, along with 311 operators. The campaign drove 25,000 visitors in less than 3 months to a City website for information; generated more than 3.1 million website impressions and almost 50,000 clicks via social media ads in 10 languages; and distributed more than 200,000 info-cards in 11 languages. A companion project by the Community Service Society of New York developed and analyzed State-level policy options for offering health insurance to undocumented immigrants. IMPROVING DIABETES CARE AND MANAGEMENT In 2008, we committed $35 million to address the diabetes epidemic in New York State. Patients deserved better. Although we knew what good diabetes care looked like, the evidence showed that practice was often falling
Foundation announces first two strategic priority areas for grantmaking: expanding health insurance coverage and improving diabetes prevention and management.
short. Our goal was to ensure that patients with diabetes got the best possible care and that clinicians achieved good outcomes for patients that kept their condition manageable, avoided complications, and controlled expenses. To meet that goal, a key strategy was to help at least 3,000 primary care providers achieve recognition for diabetes care from the National Committee for Quality Assurance (NCQA) or Bridges to Excellence (BTE). To achieve recognition, providers needed to demonstrate
not only excellent care processes—such as regular foot and eye exams for patients with diabetes—but also good outcomes: controlled blood sugar, blood pressure, and cholesterol among patients with diabetes.
EXPANDING AND PRESERVING PRIMARY CARE Since our early days, we’ve been committed to preserving and increasing access to primary care for New Yorkers—dedicating nearly $12 million in this area over the past 10 years.
We made grants to four statewide professional associations of primary care providers (the Healthcare Association of New York State, the Community Health Care Association of New York State, the New York State Academy of Family Physicians, and the New York chapter of the American College of Physicians) to get the word out to their members about the NCQA/ BTE programs and help them through the recognition process. NYSHealth also made small grants directly to providers to help them achieve recognition. Some of these awards went to large health care systems with multiple providers, but we also worked with small practices and even solo practitioners. By 2013, we made it over the finish line: 3,081 providers—approximately 25% of all New York State primary care physicians— achieved recognition. This means that more than 600,000 New Yorkers with diabetes are achieving good health outcomes.
The ACA in 2010 extended affordable health care coverage to millions more New Yorkers. It also led to increased demand for primary care, both among the newly insured and those who were left out of coverage expansions and remained uninsured.
NYSHealth releases its first RFP to expand the availability of coverage options in the State.
NYSHealth begins its Setting the Standard initiative to advance best practices in diabetes management.
Total cost of diabetes in New York State is estimated at $12.9 billion.
Seeing both the opportunity and the need, we awarded the Community Health Care Association of New York State (CHCANYS) nearly $400,000 to help 12 health centers apply for competitive New Access Point (NAP) grants from the federal Health Resources & Services Administration. In 2012, 11 of those health centers ultimately received a total of more than $25 million in NAP funding—a 64fold return on our initial investment. Another primary care grant, to consulting firm CohnReznick, supported technical assistance for community health centers that serve disproportionately large numbers of uninsured or commercially insured patients. The project helped these centers pre-
NYSHealth launches its popular “Conversation With…” series, offering an in-depth discussion on a specific health or health care issue. It debuted with Don Berwick of the Institute for Healthcare Improvement, who later became Administrator of the Centers for Medicare & Medicaid Services.
U.S. Census finds an estimated 13.2% of New York State residents were uninsured from 2004–2006.
other grant to Cornerstone Family HealthCare in 2016 to plan for further expansion in Broome County and focus on recruiting and retaining highly qualified medical staff.
Lori*, a mother of two, could not afford to buy health insurance. When we helped support the expansion of a children’s clinic in the North Country to serve adults, she no longer had to put off seeing a doctor or pay for expensive urgent care. “I am so glad that North Country Family Health Center isn’t just for children anymore. And I am so glad that I can get the same great care for myself that I do for my kids,” said Lori.
In 2013, we again worked with CHCANYS to develop a statewide expansion and sustainability plan for FQHCs. The report lays out a rational, data-based plan for building FQHC capacity through sustainable methods and has been used by policymakers to guide the expansion of FQHCs across the State.
*Name changed to protect privacy
pare for the financing changes spurred by the ACA and ensure their financial viability. In the same year, we awarded two rounds of grants to directly help establish and build the capacity of community health centers in medically underserved areas throughout the State. One recipient of these grants, Cornerstone Family HealthCare—then known as the Greater Hudson Valley Family Health Center—aspired to open what would become the first federally qualified health center (FQHC) in the entire Southern Tier region of the State, a mostly rural area with limited primary care access.
Cornerstone Family HealthCare used its first grant from NYSHealth to conduct a community needs assessment to define the gaps in primary care—as well as geriatric, dental, behavioral, and transportation needs—in the region and do crucial relationship-building. With subsequent technical assistance funded by NYSHealth, Cornerstone Family HealthCare was then able to secure federal funding to bring the first FQHC to Broome County in the Southern Tier. The new center opened early 2016 in close proximity to public housing residents and is projected to serve 1,400 patients. Because the capacity of this new clinic would still not be big enough for the large population it serves, we awarded an-
In 2014, six primary care centers in Suffolk County on Long Island, serving 53,000 mostly low-income New Yorkers, were at risk of closing because of budget deficits. We awarded Hudson River HealthCare (HRHCare) a grant to help transition the six into FQHCs to preserve care for these residents. By 2016, the newly transitioned FQHCs were able to integrate comprehensive behavioral health services and complete the paperwork necessary to integrate additional services, such as dental care and health education, at the sites. Some of the sites received subsequent federal funding in support of services. The
2008 APRIL MARCH
David Sandman joins NYSHealth as the Senior Vice President for the Foundation
NYSHealth kicks off its Veterans’ Health focus area at an event at the Rochester Veterans Outreach Center.
NYSHealth announces its priority area to integrate mental health and substance use services.
The 5-year, $35 million NYSHealth Diabetes Campaign is launched.
Riverhead site received a $400,000 NAP grant. After expanding HIV primary care services at five of the sites, HRHCare received a $925,975 grant from the Health Resources & Services Administration Ryan White HIV/AIDS Program in 2015 to support quality care for people living with HIV. Combined, the project resulted in more than $1.3 million in federal funds being leveraged. HELPING NEW YORKERS COPE WITH MENTAL HEALTH AND SUBSTANCE USE CONDITIONS Early on, we chose integrating mental health services with substance use services as one of our priority areas. Research had shown that 50% of New Yorkers who suffered from a mental health disorder simultaneously struggled with some form of substance use. Yet fewer than 1 in 10 New Yorkers who struggled with these co-occurring disorders—as many as 1.4 million people—received evidencebased treatment for both conditions. To make headway on this issue, we awarded a grant to National Development and Research Institutes to establish the Center for Excellence in Integrated Care (CEIC), investing nearly $4 mil-
New York State begins offering expanded Children’s Health Insurance Program (CHIP) eligibility to families with incomes up to 400% of the federal poverty level, opening up coverage to 70,000 additional uninsured children.
NYSHealth hosts its first statewide conference: “Reforming New York’s Individual Health Insurance Market.
greater than the sum of its parts; a single grant, even a good one, does not make a program.
For clients like Nicole*, a Staten Island resident who had spent most of her adult life battling heroin addiction and chronic depression, receiving treatment and counseling for both conditions had a transformative effect—from returning to work or school to finding permanent housing to reconnecting with family and friends. “I feel a great sense of freedom,” said Nicole.
MEETING THE NEEDS OF VETERANS AND THEIR FAMILIES In our efforts to help New Yorkers struggling with both mental health and substance use disorders at the same time, we found that returning Iraq and Afghanistan war veterans and their families were also in need of better care and support. In response, we developed a special focus area to improve services for returning veterans and their families. In 2009, we commissioned RAND Corporation to conduct the first-ever statewide needs assessment of returning veterans and their families, which found that 22% of surveyed veterans have a probable diagnosis of post-traumatic stress disorder and/or major depression.
*Name changed to protect privacy
lion over the course of five years in this project. The plan was for CEIC to help licensed mental health and substance use programs across the State make changes so they could deliver integrated services to clients with both conditions, regardless of the type of facility where they were seeking care. It was an ambitious, large-scale challenge—CEIC aimed to work with at least half of the State’s licensed mental health and substance use clinics and offer them technical assistance and best practices for integrated care. At the initiative’s start, only 22% of clinics were rated by CEIC as able to offer integrated care for clients seeking help.
NYSHealth establishes the Center for Excellence in Integrated Care (CEIC) to help mental health and substance use programs across the State integrate services for people with co-occurring conditions. NYSHealth begins accepting proposals for its Special Projects Fund.
This is the largest grant we have ever awarded to a single grantee. It was a gamble to make such a concentrated, long-term investment using one tightly focused strategy, but we believed this would give CEIC enough support and latitude to have real impact. The project was not without challenges: regulatory and licensing obstacles needed to be overcome; an array of governmental agencies, providers, and other stakeholders had to collaborate; care delivery systems had to transform.
Most importantly, the RAND report also found that half of veterans want to get care in their communities, rather than at a Veterans Affairs (VA) facility. In light of this finding, we broadened our veterans work to include a focus on expanding community-based health care and related services for veterans. In 2012, we sup-
For future initiatives of this size, we would instead use more diverse strategies and engage more grantee partners, rather than singularly targeting one goal and working with one grantee to accomplish it. A successful program is usually
Food Retail Expansion to Support Health (FRESH) initiative launched in New York City to bring more grocery stores and food markets to underserved communities.
New York Governor Paterson creates Obesity Prevention Agenda to reduce and prevent childhood obesity and related diseases such as Type 2 diabetes. APRIL
NYSHealth develops its Economic Recovery Fund to assist New York State’s nonprofit health sector during the economic downturn of the Great Recession.
NYSHealth supports a collaborative of hospital and insurers to reduce hospital readmission rates in the Bronx.
ported the Veterans Outreach Center in Rochester to develop a blueprint that can be used as a scalable model by veteran-serving organizations to build capacity and provide greater access to services. The blueprint has been used to spread the model not only across New York State—including in Utica and Buffalo—but in Colorado, Florida, Minnesota, and Rhode Island. Our grants to Syracuse University’s Institute for Veterans and Military Families helped community-based organizations across the State prepare successful proposals for funding through the Supportive Services for Veteran Families (SSVF) program. That support led to nearly $75 million in federal funding to New York organizations working to prevent homelessness among veterans and their families. We also supported more direct assistance to veterans with a grant to Iraq and Afghanistan Veterans of America, in support of its Rapid Response Referral Program. The program provides free case management help and referral services to veterans and their families, including connecting them to health care, mental health, and other social service supports throughout New York State.
As part of its Diabetes Campaign, NYSHealth inaugurates the Half the Care campaign with a social media website for providers to access diabetes management tools and resources.
For Andy*, a New York combat veteran of the wars in Iraq and Afghanistan, chronic back pain was becoming so severe that he was frequently calling out sick from his job. Depression also was compounding his problems, causing him to withdraw from friends and family. With encouragement from an Iraq and Afghanistan Veterans of America case manager, Andy agreed to pursue weekly physical treatments for his back; soon after, his back pain improved. His case manager also connected him to a nonprofit that provides free services for combat veterans, including group counseling. After attending the group, Andy told his case manager that, for the first time since he had been home from deployment, he felt able to begin addressing his trauma and depression. *Name changed to protect privacy
EMPOWERING HEALTH CARE CONSUMERS In 2016, NYSHealth launched a new priority area focused on empowering health care consumers. Too often the health care system is putting patients last, when they should come first. We want to change that dynamic and increase health care consumers’ choice, control, and convenience. We had done some previous work on transparency, payment reform, and cost containment that has helped to inform our new efforts in consumer
First Lady Michelle Obama launches the Let’s Move campaign to combat childhood obesity.
The Affordable Care Act is signed into law.
empowerment. For example, we awarded FAIR Health a grant, currently underway, to develop an online price and quality shopping tool for consumers. It is vital consumers have information that will help them make good choices about when and where to receive care— and how much they might expect to pay for that care. The FAIR Health tool will allow consumers to compare hospitals, urgent care centers, retail clinics, and individual providers, helping them to make informed decisions about their health care. We’re also supporting the launch of OpenNotes (a national initiative working to give patients access to their visit notes written by doctors, nurses, and other health care providers) at NYC Health + Hospitals. When patients have access to their own visit notes, they better remember what was discussed, feel more in control of their care, are more likely to take medications as prescribed, and can share notes with their caregivers. Bringing OpenNotes into NYC Health + Hospital’s system—the largest public hospital system in the country—will provide access to medical visit notes for many patients who have traditionally lacked such health information.
There is still more to explore in the field of consumer empowerment, and we are eager to learn from others. To jumpstart and help shape our work in this area, we issued a Request for Proposals (RFP) to fund ambitious, large-scale projects or studies that might focus on creating new tools and resources for consumers; making the health care system easier to navigate; identifying effects of consolidation; or addressing systemic, repeated problems for health care consumers. We received many creative proposals, and subsequently awarded the first round of grants in this area in late 2016. Among the projects we’re supporting through this RFP is one by MergerWatch to help protect consumers from the effects of health care system consolidations. Consolidation in the health care provider market can provide benefits but can also reduce competition and consumer choice, lead to cuts in services, and foster higher prices. This issue is typically debated by health care industry stakeholders and anti-trust monitors, but rarely are there channels for consumer input. In 2016, MergerWatch issued a national study that concluded that the Certifi-
cate of Need (CON) process to oversee hospital transactions can be updated to be more transparent and consumer friendly, enabling greater input and review from the public. Our grant to MergerWatch will support a more in-depth review of New York State’s CON process and identify opportunities for consumer engagement and protection in this era of consolidation.
NYSHealth hosts first public discussion on New York State's proposed “Soda Tax.”
NYSHealth releases a report analyzing the key provisions of the ACA and their implications for the State.
NYSHealth moves to its current office space at 1385 Broadway.
An NYSHealth report offers recommendations for how the State can improve care and curb health care costs by billions of dollars.
NYSHealth launches its Meeting the Mark RFP through its Diabetes Campaign.
Dr. Ann Albright, Director of the Division of Diabetes Translation at the Centers for Disease Control and Prevention, leads a “Conversation With” event to discuss the National Diabetes Prevention Program. NYSHealth hosts conference on the imperative of cost containment in health reform.
Developed a statewide plan to preserve and expand primary care and leveraged more than Helped
in federal dollars to expand community health centers
2.8 million New Yorkers
Scored early victories in
obtain health insurance coverage on the NY State
six communities statewide
of Health Marketplace through policy analyses,
to improve access to affordable nutritious food
outreach, and enrollment efforts
and opportunities for physical activity Preserved community water fluoridation for
14 million New Yorkers
Provided sustainable health services to
Ensured more than
refugees in Rochester and replicated
600,000 New Yorkers receive excellent diabetes care and outcomes
Commissioned the first-ever needs assessment of New York’s returning veterans and helped secure
nearly Forged agreement and understanding by organizing
$75 million in federal funding to support veteran families
182 convenings with health leaders,
10 YEARS (2006–2016)
the model in Utica and Buffalo
Used wise investment strategies that allowed us to make more than
policymakers, providers, payers, consumers, researchers, business and labor leaders, and community members
Set a health care and public health agenda by publishing more than
100 opinion pieces
$117 million in grants while maintaining a stable $280 million endowment
NYSHealth releases new study conducted by RAND Corporation detailing the needs of New York State returning veterans and their families.
New York Governor Cuomo issues executive order creating the Medicaid Redesign Team.
Below are some policy wins we are very proud of, along with a few misses and what we learned from them. MAKING THE CASE TO ESTABLISH THE BASIC HEALTH PLAN NYSHealth was one of many players focused on ACA implementation issues. Whenever practical, we coordinated our efforts with State officials and other partners to ensure that our contributions would be complementary and useful, rather than duplicative.
NYSHealth begins supporting the replication of the Y-DPP diabetes prevention program at YMCAs in 10 regions of the State.
USDA issues the MyPlate nutrition guidelines, ending 19 years of the food pyramid design.
NYSHealth holds conference to bring attention to the reintegration needs of returning veterans and highlight promising community-based initiatives to address those needs.
An NYSHealth-supported report lays out recommendations to expand and improve the role of community health workers in the workforce.
Marketplace, and more than 350,000 New Yorkers enrolled in the plan in the first two months it was offered. FINDING SOLUTIONS FOR CRIMINAL JUSTICE AND PUBLIC HEALTH REFORM Mass incarceration has emerged as a major public health problem in the United States in recent years, particularly in how we deal with criminal justice-involved individuals struggling with mental illness or substance use issues. As political support and popular sentiment for criminal justice reform grow, so does the need for effective models and sensible solutions that keep people with behavioral health issues out of the prison system and instead put them into treatment. We’ve supported some innovative projects that can offer insights and guidelines for policymakers as they move ahead with public health reforms in the criminal justice system.
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For example, the Drug Policy Alliance (DPA) is laying the groundwork for the Law Enforcement Assisted Diversion (LEAD) program in Albany. First piloted in Seattle, LEAD works to divert low-level, nonviolent drug offenders from incar-
NYSHealth marks its 5-year anniversary with its Board, CAC, and grantee partners at an event and reception at the South Street Seaport. NYSHealth releases its first RFP to promote and manage growth of community health centers in four underserved regions of New York State.
To make a difference beyond our grant dollars and achieve greater impact, we have sought to inform changes in policy and practice that will lead to a transformed health system and better health for all New Yorkers. Investing in work that either removes obstacles or creates conditions for change on the ground gives us an opportunity to make broad advancements in health that can improve innumerable lives. Over the past 10 years, we’ve earned significant reputational capital, priding ourselves on the ability to work collaboratively with grantees, policymakers, health and health care leaders, government agencies, academia, and other funders. Through these partnerships, we’ve been able to support high-quality, credible, unbiased analyses and research on timely and important
Much of the analytic work we supported did inform and shape State policies and decisions. As just one example, an NYSHealth-funded report by the Community Service Society of New York (CSS) examined what a Basic Health Plan (BHP) could mean for New York State. It found that the BHP would be an excellent option for New York, enabling as many as 600,000 New Yorkers to gain more affordable access to coverage, as well as saving the State between $300 million to $1 billion a year by bringing in additional federal funding options. In addition, a BHP could help some 100,000 uninsured residents gain access to insurance. The report’s findings were later confirmed through a separate analysis commissioned by the State. We collaborated with CSS to educate and brief policymakers about the report, including at meetings involving federal and State officials. In 2014, the New York State Assembly included a BHP in the 2014–15 and 2015–16 State budgets, which Governor Cuomo signed into law in 2015, making it one of only two programs in the nation. The BHP (now known as the Essential Plan) took effect in January 2016 through the NY State of Health
10 YEARS OF INFORMING POLICY
health policy issues—and get them into the hands of the right stakeholders who can shape policy. And as a convener, we bring together influential policymakers, leaders, health care advocates, and other experts to share ideas, models, and strategies for change through our well-attended conferences, “A Conversation With…” series, and other events on key topics—from health care coverage to population health to payment reform, to name a few. As a result of these efforts, we have emerged as a resource for information that can be used to understand or advance policy work throughout the State and beyond.
ceration, connecting them instead to behavioral health treatment programs and other supportive services such as housing and job training. DPA helped to develop this coordinated public health approach to drug policy in Albany, which has high rates of drug-related hospitalizations and residents incarcerated for drug offenses. DPA brought together community members, multiple agencies and levels of government, and health providers to develop a more effective municipal drug policy—one rooted in a public health approach. In July 2015, the White House hosted a national convening on LEAD in which Albany’s work was cited. Efforts are now underway to replicate the work on Staten Island. We also worked with the Vera Institute of Justice to introduce the use of medical parole in New York State and establish a pilot program to approve medical parole applications for inmates who are terminally ill or have significantly advanced conditions and deemed no longer a danger to society. Vera Institute of Justice is assessing current policies and practices for medical parole, seek-
2012 JANUARY JANUARY
Health Affairs’ January issue, “Confronting the Growing Diabetes Crisis,” is funded in part by NYSHealth.
An NYSHealth-supported report is released with findings that a Basic Health Plan could save New York as much as $954 million in annual health care costs and help some 100,000 uninsured residents gain coverage.
ing out appropriate community-based placement opportunities, and developing screening tools to identify potentially eligible prisoners—all of which will serve as a blueprint on the use of medical paroles for aged and infirm inmates.
the prevalence and impact of dental disease and the benefits of community water fluoridation. Informed by this work, Governor Cuomo enacted the Healthy Teeth Amendment in April 2015, which allocates State funding toward the maintenance and installation of community fluoridation systems and allows counties to apply for funding to support their machinery. The Healthy Teeth Amendment provides an Oral Health Fund—totaling $5 million in 2015 and $3.8 million in 2016—to help communities purchase, repair, or upgrade fluoridation equipment. Additionally, the amendment requires communities that want to stop community water fluoridation to provide public notice and alert the New York State Department of Health.
PROMOTING ORAL HEALTH Sometimes the most effective interventions are the simplest ones. Water fluoridation has been praised as one of the “10 great public health achievements of the 20th century” by the Centers for Disease Control and Prevention. Working with The Pew Charitable Trusts’ Children’s Dental Campaign, we set out on a threeyear effort with the Schuyler Center for Analysis and Advocacy (SCAA) to educate policymakers about the population health benefits and safety of water fluoridation. Together, we are working to mobilize communities facing decisions about community water fluoridation by building coalitions and training stakeholders to use data to support population health interventions. SCAA also developed analyses and policy briefs highlighting the cost-effectiveness of water fluoridation to educate the public and policymakers on
Our combined efforts with The Pew Charitable Trusts and SCAA to inform policy are projected to protect access to fluoridated drinking water for (and the teeth of) 14 million New Yorkers. ADVOCATING FOR UNIVERSAL SCHOOL LUNCH In 2016, we made a big push on the topic of universal school lunch: free lunch for all New York City school children, regardless of income. This
Colonel (Ret.) James D. McDonough, Jr., joins NYSHealth as Senior Fellow for Veterans Affairs.
U.S. Supreme Court upholds the ACA’s individual mandate but does allow states to opt out of Medicaid expansion.
NYSHealth awards nearly $1 million to 10 community health centers throughout the State to expand their capacity to provide primary care to patients.
sweeping policy change is consistent with our focus on creating a healthier food environment; it also reduces the stigma and bullying associated with free or reduced-price lunch. And we knew that it could be done in New York City: universal lunch is available in other areas of New York State (Rochester, Buffalo, and Albany, to name a few) and in large cities such as Boston, Chicago, Dallas, Washington D.C., and Detroit. We brought all of our resources to bear: we made a grant to Community Food Advocates to advance the work; wrote and spoke about the issue;
President Obama announces Deferred Action for Childhood Arrivals (DACA) policy to exempt from deportation certain undocumented young people who entered the country as children and allow them some benefits.
NYSHealth hosts statewide conference, “Diabetes Prevention: Scaling What Works,” to discuss opportunities throughout New York State to spread the National Diabetes Prevention Program (NDPP) and other effective programs.
“There is no reason that our children, whether they can afford to pay for lunch or they can’t, should go to a New York City public school and be hungry. This shouldn’t happen.” Monique Lindsay, founding member of the Lunch 4 Learning Campaign Parent Caucus
convened advocates and elected officials for a public discussion; met with government officials; highlighted the topic on social media; and generated media attention. Unfortunately, despite our best efforts, the measure was not included in the New York City budget adopted in 2016, even with strong support from the City Council. We were disappointed but not disheartened by the outcome; meaningful change is never easy and takes persistent effort. We, our grantee, and our other allies intend to keep fighting on this issue, and we feel confident that this pro-child, pro-health measure will become reality in the future. RUNNING INTO LEGISLATIVE ROADBLOCKS FOR DISABILITY SERVICES Policy work can be messy and unpredictable; it requires patience and flexibility. In 2012, we saw an excellent opportunity for New York State to adopt and implement Community First Choice (CFC). An option under the ACA, CFC offers states enhanced Medicaid matching funds to enable
NYSHealth establishes new priority area focused on advancing primary care.
New York State releases its 2013–17 Prevention Agenda.
An NYSHealthsupported report offers first-ever plan for building New York State’s community health center system.
people who may be eligible for an institutional level of care to stay in their homes and get services in the community. This option was a win for both the State and its most vulnerable residents, with the potential to expand access to community-based services for approximately 1 million New York Medicaid recipients, generate an estimated $90 million a year in net Medicaid savings to the State, and rebalance incentives away from institutional care settings.
Finally, in June 2016, the State resolved the barriers to implementation; New York is now one of six states participating in the CFC option. Although hindered by the legislative delays over the course of our partnership, NYAIL and CDR have continued their efforts to ensure that implementation of CFC results in the most expansive increase of access to home- and community-based services for New Yorkers with disabilities. EMPOWERING COMMUNITIES TO ADVOCATE FOR HEALTHY SCHOOLS When students at P.S. 51—a school in the Bronx sited on an old lamp factory—complained of headaches, coughs, and other health ailments over the years, parents were at a loss to explain the cause or understand what they could do to protect their children. What the parents, teachers, and the community of P.S. 51 didn’t know was that the New York City Department of Education (DOE) had conducted environmental testing of the school and had found dangerous levels of toxins left over from the school site’s past use. The DOE was under no obligation to inform the community about the environmental testing, and when it finally released a public report, it was too technical to understand—
We supported a partnership between the New York Association on Independent Living (NYAIL) and the Center for Disability Rights (CDR) to work with the State and to develop the CFC program in New York. However, the project was delayed, primarily because of a statutory change that would be needed to allow for CFC implementation in New York State. The timing of political support became an obstacle. In 2014, while the State Senate supported passage of the amendment, the Assembly did not. By early 2015, the tables had turned—the State Assembly was in favor of the amendment, but the Senate no longer supported it.
leaving parents confused and fearful about their children’s health. To help redress this problem, we awarded New York Lawyers for the Public Interest (NYLPI) a grant in 2011 to work with P.S. 51 and other school districts, offering training and assistance to help parents advocate for improvements to school siting policies and practices. NYLPI developed practical tool kits and easy-to-understand educational materials, as well as helped residents make sense of environmental reports and their health implications for students and school staff. Based on this work, New York City Council members sought out NYLPI for recommendations on best practices for healthy school siting, construction, and renovation. In 2015, the Council passed new legislation, signed into law by Mayor de Blasio, that requires the DOE to inform parents and school employees within seven days of any environmental test results that show potential health threats in existing public schools or proposed sites. The law also requires the DOE to publish all environmental inspections to its website and biannual reports for the Council and the public summarizing results from all inspections and site assessments, as well as plans to mitigate risks.
Health Affairs’ June issue, funded in part by NYSHealth, examines New York State’s Marketplace as it gets up and running and prepares to launch enrollment.
Citi Bike debuts in Manhattan and Brooklyn.
First open enrollment period begins for 2014 health coverage under the ACA.
NYSHealth releases RFP to create a statewide enrollment network of communitybased organizations to offer outreach and enrollment services to uninsured New Yorkers.
NYSHealth grantee CEIC exceeds its goal of helping 600 mental health and substance use clinics integrate care for clients with co-occurring conditions.
NYSHealth surpasses its goal of helping 3,000 primary care providers attain diabetes recognition.
“I’ve spoken to so many parents, and I can’t tell you how relieved they are that something like this law exists out there.” Marisol Carrero, parent of P.S. 51 student
STAFF REFLECTIONS What’s happened over the past 10 years on the health care/public health front that you are most excited about?
The recognition that place “matters is huge—it frees pub-
lic health practitioners to think less about how individuals can change health habits to focus on how we can collectively create places that build health.” — Lourdes Rodríguez, former Program Officer
the Affordable Care “Act!Definitely I was most excited about Medicaid expansion—even though not all states decided to expand, it made a huge difference in the ones that have, like New York.”
What one piece of advice would you give to grantees?
hesitate to contact “usDotonot share news of how you
are doing. Our eyes, ears, and NYSHealth doors are always open to celebrate your success with you or to offer advice.” —Ursula Stewart, Senior Grants Associate and System Administrator
What would you like to see happen in the health care/public health field over the next 10 years?
What was your proudest moment at the Foundation?
Hearing firsthand from our “grantee, the Southern Tier
Community Health Center, about what a difference our support made for this underserved area, how our grant prevented a health center from shutting its doors and helped nearly 1,000 patients get the care they need. Just incredible.” —Maureen Cozine,
I’d like to see health provid“ers—both general and specialists—have a true collaborative partnership with their patients.” —Brian Byrd, Program Officer
More inclusive health care “coverage Harness the power of social and access for immi“media! The network can make you stronger.” —Stephany Fong, Communications Associate
Senior Director of Communications
grants, especially the undocumented. Many are hardworking, resourceful people who contribute so much to our society—they should have the opportunity to live healthy lives and thrive in this country.”
work with Project ECHO “inOur New York. The success of
this model to expand health care delivery, improve health outcomes, and reduce costs has led to its rapid expansion and replication into new health conditions and communities.” —Bronwyn Starr, Program Officer
a former intern of “theHaving Foundation featured in an advertising campaign he inspired to get the word out that young immigrants with DACA status may be eligible for health care coverage in New York. This campaign, which we sponsored with the Mayor’s Office of Immigrant Affairs, was a great way to speak directly to people about their rights and opportunities.” —Amy Shefrin, Program Officer
—Michele McEvoy, Communications Officer
—Jessie Kavanagh, Program Assistant
As a statewide organization committed to improving the health of all New Yorkers, we are interested in supporting efforts that can have large-scale impact. Even if we sometimes start small, supporting a program at one organization or serving one community, we continually focus on how an idea that works in one place might be replicated and spread regionally, throughout the State, or even nationally. When we see a promising or proven idea, we and our grantees and partners have a role to play in testing and spreading that model to create broader impact. Though our financial resources are relatively modest for a statewide foundation, we make concerted efforts to leverage our limited dollars to achieve the most impact. To us, sharing what works means that we endeavor to collaborate with other funders and partners to replicate and spread
NYSHealth awards more than $400,000 to 25 organizations across the State to implement and grow the National Diabetes Prevention Program (NDPP).
justice system. The nation’s first Veterans Treatment Court opened in Buffalo in 2008 as a means to intervene in cases of nonviolent criminal acts by veterans and help them access rehabilitation services and seek treatment, instead of going to jail. In 2009, we funded the New York State Unified Court System (NYSUCS) to formally evaluate the program in Buffalo. NYSUCS identified the key elements of the program and developed guidelines and a training curriculum for other courts and partner agencies to bring the model to new jurisdictions. We then awarded NYSUCS a second grant in 2010 to replicate the Veterans Treatment Court across the State. NYSUCS helped establish Veterans Treatment Courts in 14 jurisdictions,
GROWING THE VETERANS TREATMENT COURT MODEL In our work on veterans’ health, it was clear that many veterans face significant reintegration challenges and are at higher risk for mental health and substance use conditions, which are often compounded by difficulties accessing behavioral health services. This in turn may increase a veteran’s risk of encounters with the criminal
NYSHealth awards grants totaling $500,000 to 17 organizations across the State to help local county health departments advance the goals of the State’s Prevention Agenda 2013–17.
Governor Cuomo announces the reinvestment of $6.2 million in Medicaid Redesign Team funds for the Delivery System Reform Incentive Payment (DSRIP) program.
With NYSHealth support, the first mental health clinic in New York State specifically designed for justice-involved people opens in Harlem.
PIONEERING PROJECT ECHO IN NEW YORK STATE In many rural areas of New York, primary care physicians must serve as mental health providers because of the shortage in physician supply. But these rural providers are often insufficiently prepared to manage behavioral issues. An innovative model, developed at the University of New Mexico, addresses this challenge. The Extension for Community Healthcare Outcomes model, or Project ECHO®, uses a Web-based model that connects rural primary care providers to specialists at academic medical centers through videoconferencing, improving access to and reducing the cost of specialty care. Instead of referring patients to costly specialists, physicians in rural areas can help save time and money by consulting with specialists remotely.
NYSHealth survey conducted by Harris Poll finds 92% of New Yorkers are satisfied with their health insurance.
1 2 3 4
More than 11,000 New Yorkers enrolled in health coverage with assistance from NYSHealth’s Enrollment Network.
The New York State Department of Health implements the State Health Innovation Plan (SHIP).
OF SHARING WHAT WORKS
training court teams on how to use the model and rehabilitate veterans. As a result of the program’s success, the model has spread throughout New York and the nation—as of 2015, more than 260 Veterans Treatment Courts are operating in 37 states, serving an estimated 13,000 veterans who would otherwise be incarcerated but are receiving treatment and support instead.
promising or proven models. Scaling a program requires solid evidence of its effectiveness. Therefore, we support an ongoing technical assistance program to help our grantees evaluate their work. Many grantees lack the capacity or experience to develop effective evaluation plans that include outcome measures and monitoring activities, and we found that they could benefit from additional assistance in strengthening the evaluation aspects of their projects. Since 2008, we have supported a formal evaluation technical assistance program, now led by the New York University School of Medicine. Through in-person group workshops and individual technical assistance, the program has enhanced the internal capacity of our grantees to conduct meaningful evaluation work.
“When I came back from training at the University of New Mexico, I thought, this is never going to work in New York. How am I going to get busy primary care physicians to come for 90 minutes, every two weeks? What we found was the quite opposite.” Michael Hasselberg, director of Project ECHO at the University of Rochester Medical Center
With NYSHealth support, the University of Rochester Medical Center established the first Project ECHO clinic in New York State, adapting the model to enhance primary care capacity to provide geriatric mental health services in rural and underserved communities. By the end of 2015, the project had grown to 500 participants across 32 counties in New York State, far surpassing its original goal of 75 participants in 8 counties. The model’s enormous success primed it for diffusion throughout the State. We briefed the New York State Department of Health (NYSDOH) on the results of the pilot, as well as its potential as a cost-saving quality improvement tool. NYSDOH ultimately recommended the ECHO model as a strategy for achieving the health reform goals of the Delivery System Reform Incentive Payment (DSRIP) program, creating an unprecedented demand for the model among leading New York health care organizations. The growth of the ECHO model has been so prolific that program evaluation has not been able to keep pace. To set clear guidelines on how
NYSHealth renews its support for a statewide Enrollment Network in advance of the third open enrollment period beginning in November.
To help spread the reach of the program beyond YMCAs, we also awarded grants to 25 organizations to implement, expand, and secure the sustainability of the NDPP in a range of settings, including hospitals, FQHCs, and workplaces across the State.
to estimate ECHO’s return on investment, we awarded The New York Academy of Medicine a grant in 2016 to support the creation of the firstever evaluation toolkit and resource guide for users of the Project ECHO model. We expect that this toolkit will help further expand Project ECHO nationally and globally.
In 2015, we awarded the Fund for Public Health in New York a grant to launch an online NDPP pilot designed to reach 1,000 New York City employees, demonstrating the feasibility of offering the program at a larger scale. As of this year, City employee health plans have been updated to include NDPP diabetes screening as part of preventive health services.
SPREADING THE NATIONAL DIABETES PREVENTION PROGRAM A key element of our work in diabetes was to replicate and spread the evidence-based National Diabetes Prevention Program (NDPP), which leads to significant weight loss among participants and reduces their risk of developing diabetes by more than 50%. We made a grant to the YMCA of New York State to replicate the Y-DPP (YMCA’s version of the NDPP) in 14 YMCA sites across 10 regions of the State. These YMCAs were able to develop their capacity to offer the Y-DPP with the same successful results of the national model.
NYSHealth launches $2 million Healthy Neighborhoods Fund initiative to help six communities in New York State become healthier, more active places. NYSHealth awards 100 millionth grant dollar, to Healthy Neighborhoods Fund.
private insurers to reimburse for the cost of the program. We are cautiously optimistic that Medicaid Managed Care plans could begin covering the NDPP for a substantial number of low-income New Yorkers at high risk of developing diabetes. REPLICATING A SUSTAINABLE REFUGEE HEALTH CARE MODEL Approximately 3,000–5,000 refugees each year resettle in New York State, the majority in the upstate region. Although refugees come from different parts of the world, many share similar health-related challenges that make it difficult for them to access health care. For many health care providers, the provision of care for refugees has proven to be a financial stress or unsustain-
“My bloodwork’s better, my cholesterol’s lower, my blood pressure’s lower. My dog loves it, she goes out for a walk every day with me.” Paul Reinecke, Y-DPP graduate
Yet there are limits to how far we can spread. We worked with the Bridgespan Group to conduct a thorough analysis on the feasibility of scaling the NDPP to serve 450,000 New Yorkers, or 10% of those with prediabetes. However, Bridgespan’s analysis found that, given our resources, scaling the program to that level would be impractical and an inefficient use of our grant dollars. Still, we continue to seek opportunities to spread the program, particularly by encouraging public and
New York becomes one of two states to receive federal approval of a Basic Health Plan.
U.S. Census numbers show that New York State’s uninsured rate dropped to 8.7% in 2014, down from 10.7% in 2013.
With NYSHealth support, the first-ever New York Scorecard on Payment Reform is released.
NYSHealth issues recommendations for building an All-Payer Database that supports price transparency for consumers.
NYSHealth awards more than $400,000 in support of community-based organizations’ and safety-net providers’ efforts to engage in DSRIP throughout New York.
some of these challenges, the model has grown into a global initiative with Rochester as its epicenter. RGH has since developed the annual North American Refugee Health Conference— one of the largest clinical conferences on refugee health globally—and the North American Society of Refugee Healthcare Providers with an information listserv of more than 1,800 subscribers.
“We had someone with diabetes arrive just a few months ago, and his diabetes had not been treated for 14 years in a [refugee] camp. He got into our program and we identified that and got him on insulin. We got the diabetes under control and got him stabilized. Now he’s working at a local hotel and providing for his family. He’s also in school right now and learning to become a nurse. Without the benefit of this program, who knows where he would be right now in terms of his medical condition, as well as his education and assimilation into the United States.” James Sutton, director of community medicine at Rochester Regional Health System
able, prompting many health care clinics to either shut their doors to new refugees or close down altogether. With our support, Rochester General Hospital (RGH) developed and piloted a sustainable, cost-efficient refugee health care model. The model helps primary care providers capture federal reimbursement funds for providing mandated health assessments to newly arrived refugees, as well as streamlines the Medicaid recertification process, resulting in continuous coverage of all eligible refugees and allowing primary care clinics to receive full reimbursement for services provided. The model has proved very successful in Rochester, where 6,000 refugee patients have since
NYSHealth focuses on two new priority areas: Building Healthy Communities and Empowering Health Care Consumers.
received care and services. In 2012, we awarded RGH a second grant to replicate the model in Utica and Buffalo, both of which have large populations of resettled refugees. RGH worked with health centers, resettlement agencies, and other stakeholders in both cities to facilitate collaborations and help implement the model, with mixed results. In Utica, RGH ran into some challenges with one of the major health centers, including staffing issues and a delay in receiving a State contract for health assessment reimbursements. However, RGH was able move ahead with implementation and connect refugees to primary care. Replication plans proved more complicated in Buffalo, with RGH encountering difficulties in advising health care providers on how to deal with their refugee health care issues; ultimately, only two health center providers agreed to use the model during the project period. Despite
More than 2.8 million New Yorkers have signed up for health care coverage through the NY State of Health Marketplace.
BRINGING PALLIATIVE CARE TO MORE NEW YORKERS Palliative care can bring significant benefits to people with serious, advanced illness or who are at the end of life, providing them with relief from the symptoms and stress of illness and improving quality of life for both themselves and their families. However, New York lagged behind many other states in 2008 when it came to the availability of palliative care programs: the State received a “C” grade in a state-by-state report on palliative care access released that year, and less than 60% of State hospitals reported that they provided palliative care services. In 2009, we awarded the Center to Advance Palliative Care (CAPC) a grant, administered through Icahn School of Medicine at Mount Sinai, to provide training and technical
Dr. David Sandman, previously Senior Vice President, named new President and CEO.
New York City Mayor’s Office of Immigrant Affairs launches NYSHealth-supported public education and advertising campaign to connect DACA recipients to health insurance.
NYSHealth releases RFP for projects that empower health care consumers in New York State.
assistance to State hospitals to establish palliative care programs, as well as strengthen the sustainability and quality of existing ones. By 2011, CAPC helped to increase New York’s report card rating from a “C” to a “B” grade, with 75% of New York State hospitals with 50 or more beds reporting they provided palliative care services. During the 2010–11 State legislative session, lawmakers passed three bills related to palliative care, one of which required New York hospitals to make palliative care available to patients who may benefit from it. Interest in palliative care has grown rapidly in the context of national health reform efforts and is now widely part of the patient care conversation, with new initiatives throughout the State supporting and advancing palliative care. For example, in 2012, the Joint Commission awarded its first nationwide advance certification for exemplary palliative care, and two of the five recipients were New York State hospitals. And following testimony from CAPC to the Medicaid Redesign Team, palliative care strategies became a central component of the State’s DSRIP program, with more than 11 provider groups working to integrate concurrent palliative care into their primary care and skilled nursing facility practices.
NYSHealth Board of Directors makes an extended site visit to the Hudson Valley region.
NYSHealth recommends how the Medicaid program and hospitals can invest in social determinants of health.
NYSHealth marks its 10th anniversary and outlines plans for the future.
Staff (as of October 1, 2016)
Community Advisory Committee Established under our founding statute, our Community Advisory Committee (CAC) has worked side by side with us from the beginning to improve New Yorkersâ&#x20AC;&#x2122; health. The CAC plays an integral role in offering guidance on our current strategies; providing regional knowledge and connections; and advising us of potential grant projects and partnerships. Our members come from all regions of New York State and from diverse backgrounds, including health and social service providers; consumer and advocacy groups; public health representatives; and the public and private sector. Their collective community voice and expert advice help to inform our grantmaking, build our statewide presence, and enlighten us to the specific health challenges and opportunities in cities and towns across the State. We thank all of our CAC members, present and past, for their invaluable community input and perspective over the last 10 years.
THE FOLLOWING PRINCIPLES GUIDE THE FOUNDATIONâ&#x20AC;&#x2122;S WORK IN ALL THAT WE DO
Establish and adhere to clear, focused goals and strategies.
Be open and transparent about our activities, successes, and failures.
Engage health experts and community leaders.
Be statewide in focus.
5 Be a learning organization interested in measuring outcomes, communicating results, and diffusing successful ideas for implementation throughout our State and beyond.
Invest in programs with sustainable and replicable prospects.
Leverage our resources to maximize the impact of our grant support.
Have processes that are user-friendly and responsive to the public.
Encourage our staff to perform at high levels and grow in abilities over time.
David Sandman President and CEO Mark Barreiro Senior Grants and Operations Manager
Amy Driver Senior Director, Finance and Operations Stephany Fong Communications Associate
Brian Byrd Program Officer
Jessie Kavanagh Program Assistant
Derek Coy Veterans' Health Officer
Michele McEvoy Communications Officer
Maureen Cozine Senior Director, Communications
Sharrie McIntosh Vice President for Programs
Elisa Nikoloulias Finance and HR Associate Amy Shefrin Program Officer Nick Smirensky Chief Investment Officer Bronwyn Starr Program Officer
Brunnie Urena Receptionist/ Senior Office Assistant Liz Ward Senior Program Assistant Olivia Williams Executive Assistant
Ursula D. Stewart Senior Grants Associate and System Administrator
Board of Directors (as of October 1, 2016) Ellen Rautenberg (Chair) President and CEO (Retired) Public Health Solutions Courtney Burke Senior Vice President & Chief Strategy Officer Albany Medical Center Mary E. Craig, M.S.H.C. President & CEO Mary Craig Consulting Services, LLC
Margaret I. Cuomo, M.D. Radiologist, Author Marc Gourevitch, M.D., M.P.H. Professor and Chair, Department of Population Health New York University School of Medicine Michelle A. Koury, M.D. Chief Operating Officer Crystal Run Healthcare
John T. Lane Managing Director (Retired) J.P. Morgan Kathleen Preston Vice President, Government Programs New York Health Plan Association
Robert G. Smith, Ph.D. Founder and Chief Investment Officer Smith Affiliated Capital Corp.