New York State Health Foundation 1385 Broadway, 23rd Floor, New York, NY 10018 Phone: (212) 664-7656 www.nyshealthfoundation.org
5-Year REPORT 2006–2011
Design by C. Rhett • psmile4me@mac.com
T
he New York State Health Foundation (NYSHealth) began operations in 2006 as a private, statewide foundation dedicated to improving the health of all New Yorkers.
To achieve meaningful impact, the Foundation is committed to making grants, informing health care policy and practice, and spreading effective programs that work to improve New York’s health system. For the past five years, NYSHealth has focused on three strategic priorities: (1) increasing the number of New Yorkers who have health care coverage and reducing health care costs; (2) improving prevention and management of diabetes; and (3) improving services for people who cope with both mental health and substance use disorders at the same time. The following principles guide the Foundation’s work in all that we do: Strive to have a tangible, positive impact on the health of New Yorkers—this is our reason for existing. Be open and transparent about our activities, our successes, and our failures. Ensure that our grant selection processes are fair and competitive so that all grant applicants— those organizations we know about and those with whom we are not familiar—have equal chances of receiving funding. Engage experts from throughout the State to help us set priorities and choose grantees. Be statewide in focus. Be a learning organization interested in evaluating our activities, communicating the results of our activities, and diffusing successful ideas for implementation throughout our State. 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.
Contents
2
Chairman’s Message
4 President’s Message
6 Five Forces That Shaped Us
10 Five Home Runs
14 Five Lessons Learned
18 Five Lives We’ve Touched
22 Five Aspirations for the Next Five Years
26 Grantees
Chairman’s Message On behalf of all of my colleagues—past and current Directors—it is with great pride that
My colleagues at the Foundation sometimes tease me for constantly urging us to focus on “game
we mark the fifth anniversary of the New York State Health Foundation. In five short years, we have
changers” that can make lasting, significant improvements. While I recognize how challenging it is
established an organization that is initiating and supporting innovative approaches to health care
to identify novel strategies in an environment as important and complex as health care, we consider
throughout the State. Our objective is simple, but challenging: to improve the health of all New Yorkers.
this our most important work.
The Foundation is principally focused on systemic change—particularly change that will increase
All of my colleagues on the Board are proud of the excellent work our dedicated staff, led by
medical coverage for those New Yorkers not now covered by health insurance and making health care
Jim Knickman, has accomplished over these first five years. We are confident the next five years
more affordable for all. We also recognize that the public cost of health care is the most significant
will be even better.
portion of New York State’s and localities’ budgets. Improving the health of our citizens during a period of constrained government expenditures is a daunting challenge. Therefore, the Foundation is not
We look forward in the next five years and beyond to helping New Yorkers live healthier lives.
principally focused on individual health delivery organizations, but rather on promising approaches that can have a broad impact throughout New York State.
January
2002 2
Empire Blue Cross Blue Shield converts from nonprofit to for-profit ownership; New York State Health Foundation established by New York State Legislature with 5% of proceeds from the conversion, estimated to be $50 million.
Carl Weisbrod, Chair, NYSHealth Board of Directors
November
2002
Deborah Konopko appointed founding Chair of Board of Directors.
2002–2006
2006
Lots of legal wrangling about how the proceeds of the conversion should be spent.
Foundation gets up and running, now with approximately $260 million in assets.
3
President’s Message As we mark the fifth anniversary of the New York State Health Foundation, my staff and I have taken time to reflect on our accomplishments, impacts, missteps, and lessons learned as we established a new organization to work on the problems facing New York’s health system. This five-year report captures the highlights. First and foremost, we have become an organization that hopes to have positive impacts by working collaboratively with great organizations—large and small—dedicated to health improvements across our State. We owe much of our success to our grantees and partners; the accomplishments of these grantees are most important to celebrate as we mark this five-year milestone. People often ask me which aspects of building a new organization bring me the most satisfaction. Two stand out: First, I am proud that we have emerged as a trusted, neutral party in the complex effort to improve health outcomes in our State. We value our ability to convene, to communicate what works and does not work, and to help the broad health community think about how public policy can lead to better uses of health care resources.
My incredibly engaged Board members, my excellent staff, and especially our ever-growing community of grantee organizations have helped make our first five years productive and stimulating. We should all look forward to continuing our shared commitment to make the improvements that are so important to all of us in the health sector.
James R. Knickman, President and CEO
April
May
June
July
July
James R. Knickman appointed as first President and CEO.
Dr. Knickman begins work as a one-person shop out of a Starbucks in NYC.
Foundation moves to 555 Eighth Avenue; hires first staff members.
New York Times article puts NYSHealth on the map ("After Four Years, Health Group for the Poor Gets Started").
First Request for Proposals issued.
2006 4
Second, I am pleased with our ability to adapt. It is stunning how much the landscape of health care has changed in New York in just five years. The economic crisis emerged in our second year of operations; the possibility of large-scale Federal health reform emerged in year three. We have had to be flexible in our strategies while remaining focused on our ultimate goal of improving New York State’s health system and keeping New Yorkers healthy.
2006
2006
2006
2006 5
Forces That Shaped Us 1
Support from New York’s health community
Across the country, the field of health philanthropy has swelled in the last 20 years with the establishment of ties created as the result of nonprofit health care organizations converting to for-profit status. New York’s health community recognized the opportunity for a strategic
N
impact. When Empire’s conversion was announced, many dedicated, committed stakeholders fought to ensure that YSHealth began operations in 2006, but
as much money as possible would be devoted to NYSHealth.
the Foundation’s history began years ear-
2
lier. In January 2002, the New York State Legislature authorized the establishment
$50 million became $265 million
of the New York State Health Foundation
While the legal wrangling ensued on the heels of the
with 5% of the proceeds from the conversion of Empire
authorizing statute and Empire’s for-profit conversion in
Blue Cross Blue Shield from nonprofit to for-profit owner-
2002, the value of the estimated assets grew more than
ship. At the time, the assets to establish the Foundation
fivefold, to approximately $265 million. This much larger
were estimated at approximately $50 million. How did
endowment meant that NYSHealth could invest more
the Foundation emerge from these roots? Five key forces
significant resources to improve New York’s health and
shaped NYSHealth’s early days:
achieve greater impact on New York’s health system.
August
September
December
January
January
NYSHealth staff numbers four.
NYSHealth hosts its first National Urban Fellow, George Suttles.
First round of grants awarded to 23 New York organizations.
Move to 1412 Broadway.
First round of grants announced at NYSHealth inaugural event at the Rainbow Room in NYC.
2006 6
foundation to foster systemic change and have a statewide
2006
2006
2007
YeaRS
hundreds of conversion foundations—philanthropic enti-
2007 7
5 Forces That Shaped Us
3
(continued)
learn from one another, seek solutions, and spread good
A Board with a vision
ideas for improving the health of communities, regions, and the entire State.
NYSHealth’s authorizing statute dictates that a nine-
5
member Board of Directors govern the Foundation—three members each appointed by the Governor, the Senate
Impressive investment returns
While much of the nation’s philanthropic sector experi-
majority leader, and the Assembly speaker. What defines our Board is the desire to make a difference. Recognizing
enced significant declines in their endowments in 2007 and
NYSHealth’s unique potential as a neutral organization
2008, NYSHealth’s investments continued to perform well
whose only interest is the public’s interest, the Board has
during the downturn. In June 2011, the Foundation’s as-
pushed the Foundation to set goals and pursue strategies
sets were slightly higher than in June 2006. Our relatively
that will have meaningful impact on the lives of New York-
stable assets during the downturn allowed the Foundation
ers, especially the most vulnerable.
to continue to make grants at a steady rate.
4
A unique niche
NYSHealth’s statewide focus on health is unique among New York’s foundations. New York State’s health system is vast and diverse, geographically and culturally. Many of the pressing health challenges we face are similar across the various regions of our State. A statewide focus allows NYSHealth to reach beyond a single health care provider or health promotion organization, and beyond individual
YeaRS
communities, to inform policies and spread solutions on a wider scale to improve the health of all New Yorkers. Working collaboratively with partners statewide, we can
February
February
March
July
Carl Hayden appointed Chair of NYSHealth Board of Directors.
Foundation announces first two strategic priority areas for grantmaking: expanding health insurance coverage and addressing the diabetes epidemic in New York State.
NYSHealth staff meets with Senator Kemp Hannon to discuss State's pressing health needs.
NYSHealth launches its “Conversation With…” series with a session featuring Don Berwick of the Institute for Healthcare Improvement, who later became Administrator of the Centers for Medicare and Medicaid Services.
2007 8
2007
2007
2007 9
Home Runs
into statute many of CSS’s recommendations to improve the
Capital District, Broome County, Buffalo, Long Island,
Employer Buy-In program. Collectively, the changes to the
Middletown, Plattsburgh, New York City, Rochester, Syra-
program lowered monthly premiums by approximately 25%.
cuse, and Watertown.
A clear goal, a talented grantee, an effective dissemination strategy, and good timing all led to a direct impact on New
The model is gaining momentum: the Centers for Disease
York State policy and improved health care coverage options
Control and Prevention provided support for an additional
for New Yorkers.
five sites in New York State, and private health plans have begun to reimburse for the pro-
2
Promoting diabetes prevention
gram, a key step toward ensuring sustainable funding for this effective community-based prevention program. As a next step, we are
In partnership with the New
S
ometimes, the right mix of timing, smart strat-
1
York State YMCA Foundation
gram in community-based settings other than
and the State Health Depart-
YMCAs to continue to increase the program’s
ment’s Diabetes Prevention
reach. Investing in a proven model, working
and Control Program, the
with good partners, and focusing on sustain-
egy, hard work, and a little luck comes together,
businesses to buy in to the Family Health Plus Program had
Foundation invested in the
ability have been essential to the success and
and a project exceeds expectations. If we could
potential to make coverage more affordable, but its original
replication of the Diabetes
spread of the program.
bottle that magic formula, every initiative would
design needed improvement. With support from NYSHealth,
Prevention Program, an ef-
turn out like these five:
the Community Service Society (CSS) of New York analyzed
fective—and cost-effective—
the program and developed actionable recommendations
model for helping people
to increase the program’s success for small businesses
with prediabetes to develop
Expanding affordable coverage for small business employees
3
A roadmap for implementing health reform in New York State
and their employees. With a solid analysis in hand, CSS and
the knowledge, skills, and
After Federal health reform was signed into
the Foundation undertook extensive communications and
behaviors needed to stay
law, it was clear that its success or failure
Opportunities for foundations to have a concrete, tangible
education efforts: we briefed State officials and legislators,
healthy. NYSHealth support-
would depend largely on states’ ability to
impact on State health policy are rare. Much of the work that
convened a diverse set of stakeholders, and built support
ed the program in YMCAs in
implement the law well. With support from
strategic foundations do surely informs policy, but actual
for the recommendations. In 2010, New York State enacted
10 regions across the State:
NYSHealth, a team at Manatt Health Solutions
September
December
January
January
First meeting of the Community Advisory Committee to ensure the Foundation receives broad input and perspective from people across the State.
NYSHealth launches consortium of the State’s leading research institutions to address the crisis in health insurance coverage.
NYSHealth launches its first "real" website.
NYSHealth staff now numbers 14.
2007 10
change is often difficult to achieve. A pilot to allow small
exploring opportunities to provide the pro-
2007
2008
2008 11
5 Home runs
(continued)
work to improve services for people coping with both mental
with other organizations during a time of financial distress.
health and substance use disorders at the same time. We
One successful outcome of this investment is expanded
and NYSHealth Visiting Fellow Deborah Bachrach devel-
identified veterans and their families as an important sub-
access to primary health care in Jamaica, Queens. When
oped a roadmap report laying out the key decision points,
population that would benefit from those efforts. As one of
St. Dominic Health Center faced imminent closure as
program elements and options, and actors needed to make
our first steps, we commissioned a report from the RAND
a result of its parent organization's bankruptcy filing,
health reform work well in New York State. The report
Corporation examining the needs of New York’s returning
nearly 4,000 patients were at risk of losing their regular
also included the first-ever estimates of the numbers of
veterans and their families. The report helped us under-
source of health care. With support from NYSHealth,
New Yorkers likely to gain coverage under health reform—
stand that, although mental health needs among veterans
the Primary Care Development Corporation, the New
1.2 million altogether.
are significant, a much broader range of issues must be ad-
York State Department of Health, and other funders, the
dressed to assure veterans’ health and well-being: outreach,
Joseph P. Addabbo Family Health Center, a Federally
The report is just one example of the importance of a grant
education, employment, and housing, as well as medical and
project being about more than money. The roadmap was
behavioral health services. The report also found that half of
has been successful: none of the participants in the Buffalo
timely and credible, and offered rigorous analysis, but
New York’s veterans prefer to receive care and services in
program have had additional encounters with the justice
perhaps the most important part of the project was get-
their communities, rather than at the VA, and that we must
system. NYSHealth has invested limited dollars in improv-
Under Addabbo’s leadership, the center has thrived, pre-
Qualified Health Center, acquired the St. Dominic Center and expanded its operations.
ting it into the hands of policymakers and other health
do a better job of providing and coordinating services in the
ing veterans’ health, less than $2 million, but we see it as
serving a needed source of care and services in Jamaica.
care leaders who would benefit from the information.
communities that our veterans call home.
an important niche area in which we can bring attention to
In one year, the center saw a 500% increase in patient
veterans’ needs, help spread models that work, and lever-
visits; expanded the range of primary care services avail-
To expand community-based services, we have supported
age existing resources.
able to include pediatrics, HIV/AIDS services, dental care,
The Foundation generated considerable media attention for the report, placed commentaries about the findings, and briefed key stakeholders on the findings. As a result,
the Veterans Outreach Center (VOC) in Rochester, which
health leaders regularly cite the report’s findings, and
connects veterans and their families to a full range of health
and an onsite pharmacy; and added 20 new health care
5 Strengthening community health centers
jobs in the community. Looking ahead, the Foundation
several have spoken of the roadmap as their “bible” on
and social services. As a next step, the Foundation has
health reform implementation.
awarded the VOC additional funding to spread the model to
Community health centers deliver affordable, high-quality
in four underserved regions in the State—Central New
other communities throughout New York State. NYSHealth
care, and it is imperative that they have solid financial foot-
York, Western New York, the Finger Lakes, and Long Is-
has also invested in replicating the Buffalo veterans treat-
ing and resources to meet the growing demand for primary
land—expand their capacity to provide primary care. By
4 Meeting returning veterans’ needs
will award grants early in 2012 to help health centers
ment court model in 10 additional jurisdictions in New York
care services. The Foundation funded a series of grants
understanding the need and identifying the right strate-
Our interest in understanding and addressing the needs
State. The model focuses on rehabilitation and reintegration
to support New York State’s nonprofit health centers in
gies and partners, the Foundation has provided timely,
of returning veterans and their families emerged from our
of veterans involved in minor criminal acts. The program
their efforts to reorganize, forge partnerships, or merge
targeted support to expand access to primary care for vulnerable New Yorkers.
March
May
May
August
NYSHealth launches its statewide Diabetes Campaign.
NYSHealth establishes the Center for Excellence in Integrated Care to improve care for people who cope with both substance use and mental health disorders at the same time.
Carl Weisbrod appointed Chair of NYSHealth Board of Directors.
NYSHealth announces commitment to improving health for veterans and their families.
2008 12
2008
2008
2008 13
Reasons
to rethinking how we deliver rehabilitation services for stroke victims, to exploring emerging opportunities in
Lessons Learned
the telehealth field. But as the grants got underway, it soon became clear that we and our grantees had in many instances been too ambitious, overpromising what could reasonably be accomplished within the scope, timeframe, and budget of the grants. Some of these were solid projects that did improve care and services, but did not meet the specific goals and expected outcomes for the projects. For example, a program in the Rochester area set out to improve home health care for 90-100 elderly residents who were deaf or hard-of-hearing. The project
N
made a difference for the clients it did reach, and satisfac-
I
came here because of the mission. I’m from a family with a high risk for diabetes and it’s so important to see what the Foundation is doing to help prevent and manage diabetes in New York State.” —Elisa Nikoloulias, Finance Associate
T
he best part is being part of the process to get the money out of the door to worthy causes. It’s a thrill to see the end result of how organizations have utilized our funds for the betterment of New York State.” —Ursula Stewart, Grants Coordinator
I
ot every project or initiative works out exactly as planned; if every grant were a home run, we would be
served during the grant period. In retrospect, project staff
’ve seen the opportunities we’ve had and the unique ability to both be neutral but also a positive force in health care. It’s exciting to work with really smart, driven, and dedicated people.”
concerned that we were not taking an appropriate level of risk. When we do fall short, or when a project
and Foundation staff realized that a more robust outreach
Yasmine Legendre, Policy Analyst
takes an unexpected turn, the Foundation is committed to learning and sharing what could have been
strategy to engage other home health agencies would have
improved. Here are five important lessons we have learned in our first five years:
been helpful upfront, and that broader policy issues related
tion scores with the services provided were very high. But the scale was not what was expected; only 34 clients were
1 Be ambitious, but realistic
to eligibility and payment for home health services were a furFoundation were eager to move full steam ahead with
When we issued our first Request for Proposals (RFP)
ambitious projects to improve the health and lives of
ther deterrent to participation.
in July 2006, we received more than 600 proposals to
New Yorkers all across the State. We awarded 23 grants,
Results like this case remind
fund a wide range of projects. Clearly, there was pent-up
which focused on everything from preventing obesity,
us that we must be diligent
demand for resources, and both the applicants and the
to improving access to care for people with diabetes,
upfront about setting realistic
I
love what I do and the people I work with; everybody does a great job to make New York better.” Brunnie Urena, Receptionist/Office Assistant
F
or me, NYSHealth breaks the stereotype of the ‘ivory tower’ foundation. I’m proud to work at a foundation that is open, transparent, accessible, and fair.” Mark Barreiro, Senior Grants & Operations Manager
November
December
January
April
First NYSHealth fall conference, on the individual insurance market.
NYSHealth staff now numbers 18.
Electrical fire breaks out in NYSHealth offices; staff displaced for one month.
Launch of first Economic Recovery Fund Request for Proposals to help New York State’s nonprofits respond to the economic crisis.
2008 14
NYSHealth Staff Come to Work
2008
2009
2009 15
5 Lessons Learned
cine was inappropriate for patients with acute care needs;
coverage among farmers, and a goal of covering 1,900 ad-
What happened? The grant scope did not include resources
lack of interoperability with other technologies needed
ditional people in 16 months or so seemed achievable. As the
or plans for marketing the site. Although the grantee
expectations for project outcomes given the strategy, size,
for complete consultations; and new State regulations
economy declined, however, and dairy farmers experienced
developed a high-quality product that could have been
and scope of the grant. Although we never want to swing
that made it more cumbersome to credential physicians
particularly tough times, the target was clearly unachiev-
a terrific resource for tens of thousands of New Yorkers,
too far in the other direction, and set expectations too low,
to deliver telehealth services.
able. Even with a flexible approach that allowed the project
hardly anyone knew about it.
(continued)
to shift focus to helping insured farmers retain their cover-
having a realistic sense of expected outcomes helps the grantee plan for and achieve success, and helps the Foun-
Rather than call it a day when it became clear that the
age, the project could not be successful given the economic
dation assess the value of a potential investment.
original strategy could not be effective, the grantee and
conditions. Ultimately, despite smart ideas, creative thinking,
2 Be flexible, and learn as you go One of the Foundation’s first rounds of grants was
the Foundation revised the scope of work for the project,
dedicated project staff, and everyone’s best efforts it became
In 2007, NYSHealth funded 12 projects through a program,
and Bassett instead focused on expanding Bassett’s
clear that there was no salvaging the project.
called Setting the Standard, to help primary care providers adopt and spread practices to improve care and manage-
earlier Telestroke initiative to additional hospitals in the region and on finding other potential uses for tele-
a good idea, but almost none of the project elements went
medicine, including home care services and evaluation
according to plan. NYSHealth awarded a grant to Bassett
of chronic conditions.
ment for diabetes. The 12 sites were diverse in terms of
4 If you build it, they may not come
their experience and expertise working with the chronic care
A grant to the Hudson Center for Health Equity and Quality supported the development of a Web-based tool that al-
the 12 ultimately achieved their expected outcomes for the
lows New Yorkers to go online to learn about health care
project. An evaluation of the project sites concluded that even rudimentary technical assistance would have helped
grantee proposed to expand its Telestroke program—
communication between the Foundation and the grantee
coverage options, determine their eligibility for public
a telemedicine program designed for stroke patients—and
organization, and a willingness on both sides to be flexible
coverage programs, and begin the application
use it to enhance care for patients with acute emergency
and creative.
needs in rural upstate New York. The project was aligned with the Foundation’s interest in increasing access to high-quality services in an underserved area of the State.
model and engaging in quality improvement, but only two of
Shifting the project focus required open and honest
Healthcare, a network of four hospitals and 23 community health centers in eight counties in Central New York. The
5 Sometimes, we need a little help
3 Know when to say “when”
many of the less-experienced grantees to
process. Online enrollment might be more ef-
understand how to assess their performance,
ficient and accurate than paper applications,
make progress on their goals, and to imple-
and could increase the number of eligible New
ment and spread appropriate models of care.
Yorkers enrolled in public coverage programs.
A better understanding upfront of what the
Another example of a good idea that turned into an unsuccessful project because of the external environment is
Although nearly 800 people logged on and com-
needed to succeed might have allowed us to
riers to implementing the project as envisioned: lack of
our work with Dairylea, which aimed to increase health
pleted an application for health insurance through
reshape the program to include more timely
buy-in from doctors, nurses, and specialists who found the
insurance for the State’s agricultural sector. At the time
the website during the grant duration, that num-
technical assistance and shared learning
technology too burdensome or concluded that telemedi-
of the initial proposal, prospects were good for expanding
ber was far less than the 14,000 expected to apply.
across the 12 sites.
August
January
March
March
NYSHealth President and CEO James R. Knickman launches his Huffington Post column with a blog about integrated care.
Deborah Bachrach joins NYSHealth as first Visiting Fellow.
NYSHealth hosts conversation featuring former State Commissioner of Health, the late Richard F. Daines, on New York State's controversial proposed soda tax.
The Affordable Care Act is signed into law, with the promise to expand health care coverage significantly for New Yorkers.
2009 16
project would require and what the grantees
Almost from the start, the project team encountered bar-
2010
2010
2010 17
Lives We’ve Touched
1
more affordable coverage options, and timely information
Monique Greenwood
of coverage changes happening now and in the future as
Bedford-Stuyvesant, Brooklyn
a result of Federal health care reform.
The owner of Akwaaba Bed & Breakfast since 1995, Monique Greenwood is committed to providing health care
“Being able to now offer health care benefits has helped me
coverage for her employees. Today, Greenwood has opened
attract and retain the best possible staff in the industry,”
additional locations in New Jersey, Washington, D.C., and
Greenwood said. And, NYC Health Insurance Link “allows
Pennsylvania, but believes that the true mark of her suc-
me to find the most affordable coverage for my staff.”
cess as a small business owner was being able to offer
2
health care benefits.
N
Donald Cortright
Circleville
At 65 years old, Donald
Greenwood now easily finds information about plans and pricing through NYC Health Insurance Link, developed by
was diagnosed with
the Human Resources Administration’s Office of Citywide
prediabetes—a condi-
YSHealth pursues ambitious goals to improve health
Health Insurance Access with support from an NYSHealth
tion that put him at
on a large scale, statewide. We want ever y New
grant. The Web-based tool, at www.nyc.gov/hilink, helps
high risk for develop-
Yorker to have health insurance coverage and access
New Yorkers find a health insurance plan that best fits
ing diabetes, heart dis-
to affordable health care. We want fewer people to
their health care needs and budgets. Business owners
ease, and stroke. He
develop diabetes, and more people with diabetes to
like Greenwood can search for and compare health plans,
was over weight and
get the right care. We want people who have both mental health and
including those with low and high deductibles; those with
had high blood sugar
substance use disorders to receive the services they need to address
and without particular benefits like prescription drugs;
and cholesterol levels.
both conditions at the same time. As we keep an eye on larger goals
and those with in- and out-of-network provider choices.
For help in getting his condition under control, Donald went
to achieve widespread changes to health care policy and practice, we
The tool provides users with a full range of comprehen-
to the Middletown YMCA, one of 10 Ys across the State that
also are motivated by the people that the Foundation and our grantees
sive health plans available in New York City from every
have implemented a diabetes prevention program (Y-DPP)
are helping every day. Here are some of their stories:*
carrier, tips to help consumers and business owners find
with NYSHealth support.
* some names have been changed.
April
April
June
July
August
NYSHealth moves across the street to 1385 Broadway, where staff decry orange walls.
NYSHealth awards the first of three grants to help New Yorkers affected by the devastating January 2010 earthquake in Haiti.
New office space floods; staff assumes locusts will be next.
NYSHealth cited as “Donor of the Day” in the Wall Street Journal.
NYSHealth releases “Implementing Federal Health Reform: A Roadmap for New York State,” outlining the key tasks required to make the most of the Affordable Care Act in New York State.
2010 18
2010
2010
2010
2010 19
his employer adjusted his schedule to accommodate
4
Over the course of the 16-week Y-DPP program, Donald
his illness, Alan was only able to work a day or two per
Mr. Pha knew no one in the United States when he arrived
learned how to make important changes in his diet and
week for a few hours at a time at his job as a Manhattan
in Rochester in 2009 as a refugee from Burma. But within
exercise habits. Before joining the program, he had not
hotel agent.
5 Lives We’ve Touched
(continued)
was exhausted and sick from his treatments. And while
his first week here, he was able to find a place to stay,
realized that the types of food and how much he ate were
systems that may be unfamiliar or confusing, like bus and other transportation schedules and public school enrollment for their children. “I now have opportunity and hope here. It’s a better life,”
receive a health screening, and get school placement as-
said Mr. Pha.
5
major contributing factors to his condition. The classes
Bills began to pile up and Alan fell behind on his rent. In
sistance with help from Rochester General Hospital and
taught him to be more aware of the total amounts of fats
addition to his life-threatening disease, Alan and his family
the hospital’s local refugee resettlement partners. Just
and calories he consumed each day and to become more
faced a lawsuit from their landlord for overdue rent and
one year earlier, the only health care option for refugees
physically active. Donald started walking more, riding a
barely had money to buy food. The family didn’t know where
like Mr. Pha was through costly trips to the emergency
Cecilia’s grandson Javier suffered from
bicycle, and doing some form of exercise most days. Useful
to turn for help. Then a social worker at the hospital con-
department; the last two clinics that had been serving refu-
asthma and had symptoms every night
tools like a food and activity tracker and a calorie-counter
nected Alan with a lawyer named Brian from LegalHealth,
gees in Rochester had closed their doors. With NYSHealth
until the family got help from the NYSHealth-
book also helped to keep Donald motivated. As a result of
a division of the New York Legal Assistance Group, an
funding, Rochester General Hospital was able to fill the
supported Healthy Homes Initiative of Make
the Y-DPP instruction he received and the lifestyle changes
NYSHealth grantee that brings together legal and medi-
void, starting a sustainable health care program that now
the Road New York. This program engaged
he made, Donald lost more than 22 pounds and his blood
cal professionals to improve the lives of low-income New
provides primary care services for thousands of refugees.
community health workers to conduct
sugar and cholesterol levels are now down.
Yorkers with serious health concerns.
“The Y-DPP classes have educated me in a way that I would not have predicted prior to these classes,” said Donald. “The positive changes that I have seen are life-changing.”
3
Alan S. Bronx
Cecilia Nolasco Bushwick, Brooklyn
home visits to help nearly 200 residents of Through this program, when Mr. Pha arrived in Rochester,
Bushwick—which has one of the highest asthma rates in
With Brian’s help, Alan and his family were able to gain
he underwent an initial health assessment, was assigned
the nation—address the asthma triggers in their home,
access to food stamps and short-term disability—provid-
a primary care provider, received health-related materials
including dust, rodents, mold, mites, and lead. The program
ing them with enough resources to cover their expenses
in Burmese, and had access to a translator when meeting
also provided legal services and advocacy, connected par-
during Alan’s treatment and recovery. Brian also helped
with doctors. In addition to receiving health care services,
ticipants to health care coverage and services, and con-
Alan apply for Social Security disability and when his initial
Mr. Pha took a course through Rochester General Hospi-
ducted community education and outreach. Make the Road
application was denied, Brian assisted him with the appeal.
tal designed to help refugees develop their interpreting
staff helped Cecilia persuade her landlord to fix the mold
Alan was in relatively good health until he developed
Eventually the family was also able to recover several
skills. Two years later, Mr. Pha is in sound health and has
and a bathroom leak in the family’s apartment. These
a tumor in 2008 and began radiation treatments at the
months in back payments to help pay their landlord for the
a full-time job, and he remains committed to giving back by
changes resulted in a significant decrease in Javier’s
age of 27—a devastating turn for him, his wife, and their
rent owed. These resources helped to pull Alan and his
staying connected with the Rochester refugee community.
asthma symptoms—he experienced symptoms only month-
two-year-old son. When he was not in the hospital, Alan
family back from the brink during a critical time.
He helps fellow refugees navigate some of the American
ly, rather than daily—and improvements in his overall health.
August
November
January
April
First investments in YMCA Diabetes Prevention Program to prevent those at highest risk of diabetes from developing the disease.
NYSHealth begins to consider new strategic priorities for 2013 and beyond.
NYSHealth releases a seminal report by the RAND Corporation on the needs of New York State’s returning veterans and their families.
First NYSHealth regional conference on diabetes in Brooklyn.
2010 20
Mr. Pha
Rochester
2010
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2 0 11 21
Aspirations for the Next Five Years
L
care services when people are in crisis. A prevention agenda, a healthy living and community health agenda, ooking forward to the future, we need to set
and a primary care agenda that keeps people from health
important that we emerge with a stronger health system,
care crises all need to emerge. And, they have to include
goals about what we hope to accomplish
more people covered with good insurance and access to
attention to the most vulnerable in our State. The Founda-
as an organization. We have two types of
care, and a more logical payment system. NYSHealth will
tion will continue to invest in community-based programs
goals: some that focus on what we hope to
continue to support analysis of the key issues related to
to help New Yorkers with diabetes—and those at high risk
accomplish related to health improvements
health reform implementation in New York State and to
for developing the disease—to develop skills and behav-
in New York, and others that focus on how we act as an
serve as a neutral convener of the health care providers,
iors to help prevent diabetes and manage complications
organization and a partner to our grantees. Five key
policymakers, payers, consumers, and others who have a
of the disease.
aspirations emerge:
role to play in shaping a reformed health system.
Make the most of opportunities related
Focus on health outcomes
1 to health system reform.
2 more than medical care services.
3 Be transparent and communicative. Being clear about what projects we fund, how we make our funding decisions, and how we invest our resources
Both Federal health reform and the pressures of the
It is essential that we shift our thinking to focus on main-
is essential to NYSHealth’s role as a responsible stew-
economic crisis create a moment of substantial change in
taining health rather than just paying for discrete health
ard of the resources entrusted to us. NYSHealth has
June
September
October
October
November
First statewide conference on meeting the needs of returning veterans and their families.
NYSHealth report finds that hospital readmissions cost $3.7 billion annually in New York State.
New York State Medicaid rolls hit 5 million people.
First statewide conference on the role of community health workers.
NYSHealth has a staff of 20 and assets of approximately $275 million. The Foundation has awarded nearly $70 million in grants throughout New York State.
2 0 11 22
how we organize and pay for health care in our State. It is
2 0 11
2 0 11
2 0 11
2 0 11
23
5 Aspirations for the Next Five Years
(continued)
always placed a high premium on transparency and
and replicate promising programs; to provide assis-
accountability: trying to make our grant application and
tance other than our grant dollars to help programs and
approval process as clear as possible, posting Grant
organizations to succeed in and to sustain their work;
Outcome Reports to our website to share lessons from
and to spread effective programs, lessons, and models
individual investments, making the Foundation’s finan-
throughout New York State. Much of what we are learn-
cial statements easily accessible. With the launch of our
ing and doing in New York has national implications, as
new website in early 2012, we will share publicly our
well. The leadership, innovation, and energy that are the
Organizational Scorecard, which tracks our progress
hallmarks of New York’s health system can inform and
toward specific per formance targets related to our
shape national policy and practice, and as leaders we can
program goals; our ability to communicate, learn from,
help to ensure that New Yorkers are well positioned to
and replicate our work; our reputational capital; and
take advantage of Federal resources.
our overall effectiveness as an organization. And, as we grow in experience and have more lessons to share, we are focused on improving the way we capture and share lessons and stories more effectively.
5 Stay focused and strategic. The most consistent feedback we hear from our stakeholders and grantees is that NYSHealth should stay the course.
Leverage and spread, even beyond
4 New York.
24
We agree! We cannot possibly take on every challenge or opportunity that New York’s health system has to offer; the need is too great and our resources too limited. To be
NYSHealth’s financial resources are relatively modest;
effective, we need to make smart choices and stay focused
the $15 million or so we spend annually is 0.03% of what
on the key strategic areas in which we can have the most
New York’s Medicaid program spends. Our approach has
impact. At the same time, we want to remain flexible and
been to focus on how we can leverage limited dollars
nimble enough to meet the evolving needs of New York-
to achieve the most impact. NYSHealth has worked to
ers as the landscape changes, and as new opportunities
collaborate with other funders and partners to support
emerge within our areas of focus.
1.2 million more New Yorkers are poised
to gain
health care coverage by 2014.
25
Grantees Action for a Better Community
Buffalo Psychiatric Center
Community Catalyst (MergerWatch)
Fractured Atlas Productions
Active Minds
Callen-Lorde Community Health Center
Frances Schervier Home and Hospital
Actors Fund of America
CapitalCare Medical Group
Community Health Care Association of New York State
Adirondack Medical Center
Catholic Charities of Onondaga County
Affinity Health Plan (Coalition of New York State Public Health Plans)
Center for Effective Philanthropy
AIDS Community Services of Western New York, Inc. Albany Medical College American Cancer Society Eastern Division (Albany) American Cancer Society Southern New York Region Amida Care Anthony Jordan Health Center
Center for Governmental Research Center for Health Care Strategies Charles B. Wang Community Health Center Children’s Defense Fund City University of New York (CUNY) Hunter College of New York
Benjamin J. Leeman, M.D., P.C.
City University of New York (CUNY) Hunter College School of Social Work
Beth Israel Medical Center Division of Endocrinology
City University of New York (CUNY) Lehman College
Better World Advertising
Coalition of Behavioral Health Agencies
Bridges To Excellence
Columbia University College of Dental Medicine
Brooklyn Alliance, Inc. Brooklyn Community Foundation Brooklyn Hospital Center Brownsville Community Development Corporation
26
Center for Excellence in Health Care Journalism
Columbia University Mailman School of Public Health Commission on the Public’s Health System Common Good Institute
Community Health Care Services Foundation Community Health Center of Buffalo Community Service Society of New York Consumers Union Cornell University Cornell University - Joan & Sanford I. Weill Medical College Dairylea Cooperative Delmar Family Medicine Dr. Martin Luther King, Jr. Health Center Empire Justice Center EPIC - Every Person Influences Children Excellus Health Plan Family Health Network of Central New York The Floating Hospital Foundation for Long Term Care Foundation for Quality Care
Fund for Public Health in New York Genesee Valley Group Health Association Georgetown University Glens Falls Hospital Grantmakers for Effective Organizations Grantmakers in Health Greater New York Hospital Foundation Greenwich House Haitian American Cultural and Social Organization Hartwick College Health and Welfare Council of Long Island Health Association of Niagara County Health Management Associates Health Ministry of the Southern Tier, Inc. Health Research (Center for Health Workforce Studies) Health Research
Over the Last 5 Years…
Healthcare Association of New York State (HANYS)
Korean Community Services of Metropolitan New York
Mental Health Association of New York City
NDRI State, Inc. (National Development and Research Institutes)
His Branches
Lake Research Partners
Monroe Plan for Medical Care
New York Academy of Medicine
Home Aide Services of Eastern NY (The Eddy)
Lansingburgh Family Practice
New York Association for Brain Injured Children
Hospital Educational and Research Fund
LIPIX, Inc.
Montefiore Medical Center The Care Management Company of Montefiore Medical Center Mosholu-Montefiore Community Center
New York Chapter, American College of Physicians
Hudson Headwaters Health Network Hudson River HealthCare Ibero-American Action League Institute for Community Living Institute for Family Health Institute for Leadership Iraq and Afghanistan Veterans of America Island Peer Review Organization Jamaica Hospital Jericho Road Ministries Jewish Board of Family and Children’s Services Joseph P. Addabbo Family Health Center
The Lewin Group Long Beach Medical Center Long Island Community Foundation Long Island Home (South Oaks Hospital)
Mount Sinai School of Medicine Center to Advance Palliative Care
Low Income Investment Fund
Mount Sinai School of Medicine Department of Health Policy
Make the Road New York
Nassau Health Care Corporation
Manatt Health Solutions
National Association of Social Workers (New York State Chapter)
Manhattan Institute for Policy Research Manufacturers Association of the Southern Tier Marcellus Family Medicine
National Center on Addiction and Substance Abuse at Columbia University
Marianne LaBarbera, M.D.
National Committee for Quality Assurance
Mary Imogene Bassett Hospital,
National Council on Aging
Mathematica Policy Research
National Multiple Sclerosis Society NYC Chapter
MDRC
New York Blood Center
New York City Alliance Against Sexual Assault New York City Health and Hospitals Corporation New York City Health and Hospitals Corporation - Bellevue Hospital Center New York City Health and Hospitals Corporation Elmhurst Hospital Center New York City Health and Hospitals Corporation - Harlem Hospital Center New York eHealth Collaborative New York Health Plan Association Council
Joslyn Levy & Associates, LLC
Medicare Rights Center
National Opinion Research Center
New York Health Purchasing Alliance (HealthPass)
Keuka Family Practice Associates, LLP
Memorial Sloan-Kettering Cancer Center
National Urban Fellows
New York Immigration Coalition
National Urban League
New York Lawyers for the Public Interest
NYSHealth has awarded 335 grants to 234 grantee organizations, totaling $68.4 million.
27
Grantees
(continued)
New York Legal Assistance Group
NYCRx
Robert Morrow Family Practice
New York State Academy of Family Physicians (AFP)
One River Grants
Rochester General Hospital
Our Lady of Lourdes Memorial Hospital
Rochester Institute of Technology RotaCare
Transition Network
P2 Collaborative of Western New York
UB Family Medicine
Paraprofessional Healthcare Institute
Rural Health Network of South Central New York
Unite Health Center
Partnership for Results
S2AY Rural Health Network Inc.
United Hospital Fund of New York
Peter Forman, M.D.
Safe Space NYC
Philanthropy New York
Schenectady Inner City Ministry
United Neighborhood Houses of New York
Phipps Community Development Corporation
Seneca Nation Health Department
Planned Parenthood of New York City, Inc.
Small Business Majority
New York State Catholic Health Plan (Fidelis Care New York) New York State Dental Foundation New York State Unified Court System New York State YMCA Foundation New York University College of Dentistry New York University College of Nursing New York University Robert F. Wagner Graduate School of Public Service New York University School of Medicine New Yorkers for Accessible Health Coverage
PMB Healthcare Consulting
Southern Tier Community Health Center Network (Universal Primary Care)
Northeast Business Group on Health
Primary Care Development Corporation
Northern New York Rural Behavioral Health Institute Northern New York Rural Health Care Alliance
Social Interest Solutions Social Ventures (Ithaca Health Alliance)
Preferred Health Partners
Northeast Health
Smith House Health Care Center
Plattsburgh & Clinton County Chamber of Commerce
Nonprofit Finance Fund Northeast Community Council
28
Planned Parenthood of Northern New York
Seton Health System
Project Equinox Project HOPE-The People-to-People Health Foundation (Health Affairs)
Southern Tier Health Care System Southwestern Medical Associates Spitfire Strategies St. Joseph’s Hospital Health Center
Taconic Health Information Network and Community (THINC) Tides Center
United Way of Long Island Unity Health System Unity House of Troy Universal Fellowship of Metropolitan Community Churches University of Michigan University of Rochester University of Rochester Environmental Health Sciences Center University of Rochester Starlight Pediatrics
Staff (as of November 1, 2011)
Uptown Medical
James R. Knickman President and Chief Executive Officer
Veterans Outreach Center Village Center for Care
Project Renewal
St. Lawrence County Health Initiative
Visiting Nurse Service of New York
Public Health Solutions
Sunset Park Health Council (Lutheran Family Health Centers)
Welsh Analytics Westfield Memorial Hospital
SUNY - University at Albany Center for Excellence in Aging Services
What To Expect Foundation
Northern Oswego County Health Services
Queens Library Foundation
Northwest Buffalo Community Health Care Center
RAND Corporation
NYC Human Resources Administration’s Office of Citywide Health Insurance Access (OCHIA)
Research Foundation for Mental Hygiene
Rapha Family Medicine Real World Foundation
Riverdale Family Medical Practice
SUNY - University at Buffalo Department of Family Medicine Syracuse University - Maxwell School of Citizenship and Public Affairs
YeaRS
William F. Ryan Community Health Center Working Today (Freelancers Union) Young Adult Institute
Mark Barreiro Senior Grants and Operations Manager
Brian Byrd Program Officer
Margaret L. Figley Communications Officer
Jacqueline Martinez Senior Program Director
Barbara Notarile Executive Assistant
Nick Smirensky Chief Investment Officer
Maureen Cozine Communications Director
Amy A. Lee Senior Program Assistant
David Sandman Senior Vice President
Bronwyn Starr Program Associate
Amy Driver Director of Finance and Operations
Yasmine Legendre Policy Analyst, Diabetes Policy Center
Michele McEvoy Communications Associate
Amy Shefrin Program Officer
Ursula D. Stewart Grants Coordinator
Elisa Nikoloulias Finance Associate
Brunnie Urena Receptionist/Office Assistant Normandy W. Villa Program Assistant
Board of Directors (as of November 1, 2011) Carl Weisbrod (Chair) Partner HR&A Advisors Clinical Professor and Academic Chair New York University Schack Institute of Real Estate Paul Bader Principal Starcraft Press
LaRay Brown Senior Vice President for Corporate Planning, Community Health, and Intergovernmental Relations New York City Health & Hospitals Corporation
Angela Diaz, M.D., M.P.H. Jean C. and James W. Crystal Professor of Pediatrics and Community and Preventive Medicine Mount Sinai School of Medicine
Jo-Ann Costantino Chief Executive Officer, The Eddy
Lucy N. Friedman, Ph.D. President The After-School Corporation
John T. Lane Managing Director (Retired), J.P. Morgan John L. Palmer, Ph.D. University Professor and Dean Emeritus Syracuse University, Maxwell School of Citizenship and Public Affairs Robert G. Smith, Ph.D. Founder and Chief Investment Officer Smith Affiliated Capital Corp.
29