Grants and Outcomes
1989; Project HOPE; Volume: 8; Issue: 1 Linguagem: Inglês
10.1377/hlthaff.8.1.203
ISSN2694-233X
Tópico(s)Primary Care and Health Outcomes
ResumoGrantWatch Health AffairsVol. 8, No. 1 Grants and OutcomesPUBLISHED:Spring 1989Free Accesshttps://doi.org/10.1377/hlthaff.8.1.203AboutSectionsView PDFPermissions ShareShare onFacebookTwitterLinked InRedditEmail ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsDownload Exhibits AbstractIndependent foundations' primary focus is grant making. In general, their assets come from the gift of an individual or family. Community foundations' assets usually come from many donors rather than a single source, and grant making is limited to a particular region. Community foundations are usually classified as private charities under the tax law and are subject to different rules and regulations than are other private foundations.TOPICSGrantsHIV/AIDSElderly careSupplemental Security IncomeChildren's healthEducationClinicsNursesHealth servicesNursingII. GRANTSAccess To CareSome thirty-seven million Americans are without health insurance. The demographics of these people are diverse, and their ranks continue to grow as the service industry burgeons and as competition in health care increases. Regional disparities in access exist as well. Foundation funding in this area ranges from economic analyses of the problem to direct provision of care.Independent Foundation Grants:Leadership Program for Community Foundations. Nineteen community foundations nationwide were awarded grants to address a range of local problems including teen pregnancy, affordable child care, school dropout, and housing and health care for the poor. Ten community foundations that received $500,000 grants must match their award on a two-to-one basis, which would add $1 million each to their individual foundation funds. The program, a Ford Foundation initiative that began in 1986, has received support from The John D. and Catherine T. MacArthur Foundation to strengthen the grant-making activities of community foundations. $3.8 million over five years. Funded by the Ford Foundation.$2 million over five years. Funded by The John D. and Catherine T. MacArthur Foundation.Selected grants:The Central New York Foundation, Syracuse, NY. $500,000 over five years to support strategies to develop affordable, high-quality day care. The Greater New Orleans Foundation, New Orleans, LA. $500,000 over five years to support a joint effort with the Alliance for Human Services, a 180-member agency coalition, to combat teen pregnancy. The Tucson Community Foundation, Tucson, AZ. $500,000 over five years to support efforts to improve coordination of children's mental health services. Community Foundation Grants:New England Health and Poverty Action Center, Boston, MA. Funding will aid the work of groups and institutions in reducing health disparities related to poverty. The project's specific focus includes developing conferences on the role of foundations in addressing health and poverty; creating a community consultation service to advise agencies in development and evaluation; and sponsoring a “working group” to develop programmatic strategies for health and poverty issues. The center is sponsored by the Tufts University Department of Urban and Environmental Affairs. $100,000 over three years. Funded by The Boston Foundation.Presbyterian Health Services Corporation, Charlotte, NC. Funding will support a free medical clinic for homeless people in Charlotte, North Carolina. The clinic is staffed by volunteer health professionals, and clerical workers. Sixty doctors and twenty nurses provide free nonemergency medical care. The clinic has been in operation since December 1987 and is administered by the Presbyterian Hospital, the Charlotte Memorial Hospital and Medical Center, and other community organizations. The Uptown Day Shelter in Charlotte has donated space for the clinic. $17,500 over one year. Funded by The Duke Endowment.Project Alivio, Chicago, IL. A coalition of seven community groups will receive funding for comprehensive health services for three neighborhoods that are home to one-fourth of Chicago's Hispanic population. Funding will support an insurance program to provide primary care to the uninsured. $45,600 over one year. Funded by The Baxter Foundation.AIDSAlthough foundations traditionally have avoided disease-specific giving, the immediate threat posed by acquired immunodeficiency syndrome (AIDS) has caused many foundations to redefine their grant-making policies. A 1988 report found that the level of giving for AIDS research and education has topped $51 million and continues to increase.Independent Foundation Grants:AIDS Prevention and Service Projects. To prevent the spread of AIDS and to care for people affected by AIDS, fifty-four grants ranging in size from $5,351 to $1,831,191 have been awarded to twenty-five states, Puerto Rico, and the District of Columbia. More than half of the grants have been awarded to community organizations, as well as religious organizations, hospitals, local health departments, and other groups. $16,678,104 over one to four years. Funded by The Robert Wood Johnson Foundation.Selected grants:Albany Medical Center, Albany, NY. $1,138,256 over three years to develop hospital-based clinics for mothers and infants infected with the human immunodeficiency virus (HIV), the virus that causes AIDS, in the mid-Hudson area. Catholic Counseling Center, Cleveland, OH. $496,227 over three years to support AIDS education and prevention programs for Hispanic youth and their parents. Children's Hospital National Medical Center, Washington, DC. $1,084,465 over four years to support the HIV pediatric care program. Activities will include training professional and volunteer staff, expanding outreach efforts to patients infected with HIV and their families, and preventing the spread of AIDS among adolescents. Prevention will be a main component of the comprehensive health services. Girls Clubs of America, Inc., New York, NY. $211,975 over two years to support efforts to educate girls about HIV transmissions and AIDS risks using educational materials funded by the grant. National Association of People With AIDS (NAPWA), Washington, DC. $90,546 over one year to strengthen local coalitions of people with AIDS and to establish these groups in their communities. South Shore Mental Health Center, Incu., Brighton, MA. $1,831,191 over four years to provide a range of intervention services to mothers and children with an HIV-positive relative. Funds also will provide a day care center for HIV-positive children in Boston's South Shore area. University of Maryland, College Park, MD. $235,781 over two years to support AIDS education, prevention, and risk reduction directed to a low-income, black housing project outside of Washington, D. C. A cooperative effort by community organizations, housing project residents, and the university will evaluate the effectiveness of AIDS education messages. The final goal of the project is to develop culturally sensitive AIDS education materials to distribute to 2,500 project residents. Harvard AIDS Institute, Harvard University, Cambridge, MA. This grant will facilitate collaborative research on AIDS at Harvard University. The institute will bring together the researchers and their resources from several departments including basic and clinical sciences, policy, law, international health, and ethics. The goal is to strengthen research efforts already under way and those planned for the future. Harvard University will contribute $100,000 to the institute. $100,000 over one year. Funded by The Charles A. Dana Foundation.Intergovernmental Health Policy Project (IHPP), George Washington University, Washington, DC. Funding will support an AIDS information network to serve five national associations representing U.S. govenors, legislators, mayors, and city and county officials. IHPP's AIDS Policy Center will track, analyze, and disseminate legislation, state and local funding data, and public policies relating to AIDS. $502,775 over two years. Funded by The Robert Wood Johnson Foundation.Project Reach. Awards have been granted to nine outreach programs nationwide to provide AIDS education to high-risk populations including young people, minority groups, and intravenous (IV) drug abusers. Metropolitan Life Foundation and Metropolitan Life Insurance Company have contributed $5.5 million over the past two years to AIDS education programs. $150,000 over one year. Funded by The Metropolitan Life Foundation.Selected grants:Child Welfare League of America, Washington, DC. $23,000 over one year to sponsor a series of conferences, “Institutes on Children and AIDS,” in several major cities for residential group care providers. Covenant House, New York, NY. $25,000 over one year to support a health educator for the Outreach Van Program, which reaches homeless adolescents. KCTS (Channel 9), Seattle, WA. $23,000 over one year to this Seattle public television station to sponsor AIDS education programs developed by teenagers. National Association on Drug Abuse Problems, New York, NY. $20,000 over one year to develop experiential/behavioral AIDS education workshops for recovering IV drug abusers, their families, and friends. National Network of Runaway and Youth Services, Washington, DC. $19,000 over one year to support the “Safe Choices” project and to develop policies for vulnerable youth in member runaway centers. Urban League of Southwestern Connecticut, Stamford, CT. $20,000 over one year to train outreach staff for an AIDS education program aimed at black and Hispanic women. University of California, Los Angeles, School of Medicine, Los Angeles, CA. Funding will support efforts to survey the AIDS testing policies and practices of 600 U.S. hospitals. Interim survey results are expected in mid-1989. The final survey results should provide information on monitoring changes in future hospital policies and practices. $351,410 over one year. Funded by The Robert Wood Johnson Foundation.Health Care For The ElderlyBy the year 2000,13 percent of the U.S. population will be over age sixty-five. Planning for the financing and humane provision of medical and social services for this group is becoming an urgent task for both the public and private sectors. Foundations are devoting resources to all aspects of the challenge.Independent Foundation Grants:E.Q.V. Research and Development Foundation, Columbia, SC. Funding will support a study of barriers that the elderly face when applying for Supplemental Security Income (SSI) and Medicaid benefits. The study contracted with Sara Shuptrine and Associates, a Columbia-based research firm, to examine why some applicants are denied benefits from a policy and procedural standpoint. $40,000 over one year. Funded by The Villers Foundation.Jewish Home and Hospital For The Aged, New York, NY. Alzheimer's disease affects approximately two to three million people over age sixty-five, and 20 percent of those over age eighty. This grant will support the Emergency Respite Care Program For Alzheimer's Patients, which will provide shortterm care (three to seven days) in the patient's home. Fees will be determined on a sliding scale, and Medicaid patients will be accepted. This grant is supported by the MONY Financial Services Foundation, which does not usually grant such large awards in the health field. $114,000 over one year. Funded by the MONY Financial Services Foundation.Oregon Department of Human Services, Salem, OR. Funding will support efforts to develop long-term care insurance for the state's elderly. Funds will be used to conduct surveys to determine long-term care service needs, to gather data on projected expenditures, and to design a model of home and community-based care with the cooperation of government officials and private-sector individuals. This planning grant is funded through the Program to Promote Long-Term Care Insurance for the Elderly, a $3.2 million Robert Wood Johnson Foundation national program begun in 1988. $$300,949 over eighteen months. Funded by The Robert Wood Johnson Foundation.Health Promotion/Disease PreventionResearch continues to document the effect that diet, exercise, and lifestyle have on health status. Preventable illness and injury claim over a million American lives each year. In 1986, over twelve million potential years of productive life were lost, costing the nation hundreds of billions of dollars. As these huge costs become apparent, foundations join the effort to promote healthy behavior.Independent Foundation Grants:The International Task Force for Disease Eradication, The Carter Center of Emory University, Atlanta, GA. Funding will support work to eradicate five major diseases— measles, polio, rabies, yaws, and guinea worm—that afflict millions of people around the world. Research will be modeled after the campaign to eliminate smallpox worldwide. Task force members will involve international health organizations and will locate monetary resources required for each disease eradication campaign. $370,000 over two years. Funded by The Charles A. Dana Foundation.The United Way, Bridgeport, CT. Funding will support the Regional Youth Substance Abuse Project to reduce drug and alcohol abuse among youth in the greater Bridgeport area. The project will develop a communitywide system of prevention, assist in early identification of users, and provide treatment and follow-up care to project participants. Funding will support an assessment and case-management service, which will be used to create individual treatment plans, make referrals to local treatment centers, and monitor participants' progress through treatment. $671,721 over two years. Funded by The Robert Wood Johnson Foundation.Community Foundation Grants:Smoke-Free Lehigh Valley Year 2000, Allentown, PA. Funding will support an antismoking education program to encourage a smoke-free community in the Lehigh Valley by the year 2000. The proposed twelve-year project aims to reduce the number of smokers from the current 30 percent to 5 percent. The program will be administered by the Allentown Health Bureau, local hospitals, and voluntary health organizations. The National Cancer Institute will share information on government-sponsored smoking cessation projects. $480,049 over three years. Funded by The Dorothy Rider Pool Health Care Trust.$393,917 over three years. Funded by The Henry J. Kaiser Family Foundation.Information DisseminationTracking and understanding the dynamics of the changing health sphere is an imposing challenge to anyone involved in the policy process. Data are fragmented, federal policies are confusing and continually revised, and innovation in the business community continues at a hectic pace. Foundations have funded several attempts to gather and disseminate information in a useful, efficient, and timely manner.Independent Foundation Grants:Nursing Tri-Council, New York, NY. Funding will support a nationwide multimedia public relations campaign to promote the professional image of nursing. The program will be administered by the National League for Nursing. The Tri-Council comprises the American Nurses* Association, the American Association of Colleges of Nursing, The American Organization of Nurse Executives, and the National League for Nursing. $800,000 over two years. Funded by The Pew Charitable Trusts.International HealthThe health problems facing less-developed countries are overwhelming. High birth rates, poor maternal and child nutrition, vector-and water-borne diseases, and now AIDS have taken a large toll, especially on infants and children. Foundations have funded continuing medical education, tropical disease research and control, family planning, and nutrition.Independent Foundation Grants:Community Organization for Research and Development, University of Natal, Durban, South Africa. Funding will support a primary health care program for black villagers in the Pongola area of northern Natal. The program will be administered by the Mboza Project, a community organization, whose health committee will establish a health center. The health center will be assisted by a network of village health workers and will serve as a model for health services elsewhere. $275,000 over three years. Funded by The Henry J. Kaiser Family Foundation.Health Services Development Unit, University of Witwatersrand, Johannesburg, South Africa. Funding will train primary health care nurses and emphasize the societal concerns and medical needs of village communities throughout South Africa. $345,000 over three years. Funded by The Henry J. Kaiser Family Foundation. Population Council, New York, NY. This grant will support a new program, Improving the Quality of Family Planning and Related Reproductive Health Care Services, to improve family planning and reproductive health services in developing countries. $400,000 over twenty-eight months. Funded by the Ford Foundation. Maternal, Child, And Adolescent HealthIn 1986, the United States's infant mortality rate ranked eighteenth worldwide, dropping from sixth thirty years ago. Morbidity, especially complications from low birthweight, is also a problem. Teen pregnancy, poor nutrition, and reduced access to health care among the poor have been suggested as causes for these statistics. Addressing these specific needs has become a top priority for several foundations.Independent Foundation Grants:Comprehensive Pupil Services Education Center (CPSEC), Memphis, TN. This grant will support a cooperative effort by private and public health centers and CPSEC to provide medical and mental health services, counseling for parenting skills, and day care to teenage mothers and their infants. Graduates of the program will be provided job opportunities through the University of Tennessee. $608,888 over three years. Funded by The W.K. Kellogg Foundation.Tri-County Children and Family Services, Inc., Covington, TN. Funding will support a program to prevent teen pregnancies in two economically depressed, rural counties in Tennessee. The program will focus on nutrition, hygiene, sex education, and family planning. Funds will support efforts to teach life skills, leadership, decision making, and assertiveness training. Funding will support a program evaluation to determine the effectiveness of preventing teen pregnancy in a disadvantaged population. $215,358 over three years. Funded by The Henry J. Kaiser Family Foundation.Community Foundation Grants:Futures Unlimited, Inc., Wellington, KS. Funding will support an intervention and rehabilitation demonstration project for the state of Kansas for handicapped newborn infants to age two. An individual family service plan will be developed for each infant, consisting of selected activities to foster speech development, eye/hand coordination, and motor skills. Families will be taught ways to enhance the development of the handicapped child. Funding also will support programs to increase public awareness of the major causes, and in some instances, prevention, of birth defects. $162,000 over three years. Funded by The Wesley Foundation.University of Chicago Hospitals, Chicago, IL. Funding will support “Beautiful Babies… Right From The Start,” an eighteen-month multimedia educational campaign initiated in June 1988. The project has received assistance from WBBM-TV (Channel 2) to promote awareness of the importance of prenatal care. An incentive program that encourages pregnant women to get early and consistent prenatal care also urges them to request a free coupon book of donated or discounted goods and services. The coupons can be validated when pregnant women visit their health care providers for prenatal care. $140,000 over one year. Funded by The Chicago Community Trust.Medical Practice (Quality, Outcome, And Variation)The high cost of health care and society's changing needs have stimulated a great deal of innovation. However, along with this experimentation has come uncertainty about the effects of the changes on the quality and outcome of medical services. Foundations are funding extensive research projects to determine what constitutes good care and how to achieve and sustain it.Independent Foundation Grants:InterStudy, Excelsior, MN. Quality Quest, a subsidiary of InterStudy, a health maintenance organization (HMO) policy think tank, will receive funding for a demonstration project for an outcomes management system. The system will be tested on several large health care management organizations to determine if health status assessment can be made a routine part of health care. $250,064 over six months. Funded by The Henry J. Kaiser Family Foundation. Joint Commission on Accreditation of Healthcare Organizations (JCAHO), Chicago, IL. This grant will support a study to develop approaches for efficient data collection on anesthesia outcomes in seventeen pilot site U.S. hospitals. This project is part of the Joint Commission's “Agenda for Change,” a nationwide program to develop a performance-oriented accreditation system. The effort currently focuses on anesthesia and obstetric care but eventually will cover all areas of care. $50,450 over one year. Funded by The Prudential Foundation.Mental HealthMental illness ranked as the third most expensive health care category in 1980, accounting for more than $20 billion of health care expenditures, according to the US. Department of Health and Human Services. Mental health coverage for many Americans remains inadequate. As many as one-third to two-fifths of the homeless population are affected by mental illness. A number of foundations are addressing this national health issue.Independent Foundation Grants:The Johns Hopkins University, Baltimore, MD. Funding will support an evaluation of Community Support, Treatment, and Rehabilitation (COSTAR), a mobile treatment unit that assists severely mentally ill people with treatment, support, and rehabilitative services. The goal of COSTAR is to help participants improve their quality of life, reduce hospitalizations, and participate actively in the community. An evaluation team will consist of psychiatrists, economists, social workers, and others. $371,021 over thirty-nine months. Funded by The Henry J. Kaiser Family Foundation.III. OUTCOMESGrant Outcomes:Boston University's Center for Educational Development in Health (CEDH). Some experts believe that health promotion and disease prevention could receive greater emphasis in medical and nursing schools. For this reason, The W.K. Kellogg Foundation awarded a nine-year grant (1979-1988) totaling $2,915,405 to CEDH to develop a model curriculum in preventive medicine for U.S. medical schools. In collaboration with the Association of Teachers of Preventive Medicine in Washington, D.C., CEDH designed and published a nineteen-volume instructional system entitled Health Maintenance in Clinical Practice, which has been tested and distributed to eight academic health centers. For more information, contact: Hannelore Vanderschmidt, Codirector, Center for Educational Development in Health, 67 Bay State Road, Boston, MA 02215.The Geriatric Assessment and Care Management Clinic , created in 1987 at the University of Arizona College of Medicine, was designed to provide a model center of co-ordinated geriatric care. The clinic treats patients with multiple chronic illnesses, educates geriatric specialists, provides comprehensive quality of care, and conducts research in all aspects of geriatrics. Clinic staff include a pharmacist, a nutritionist, a social worker, a clinic coordinator, and physicians. “There was a need for a quality geriatrics clinic because of Arizona's high elderly population and because the_university's gerontology program needed to be complemented by a geriatrics medical training program,” said John W. Murphy, executive director of The Flinn Foundation. In 1986 the clinic received a five-year grant of $1.5 million from The Flinn Foundation. For more information about the clinic, contact: John T. Boyer, Director of Restorative Medicine, University of Arizona Medical Center, Tucson, AZ 85725.Interfaith Volunteer Caregivers Program (IVCP) , a three-year program, was designed to support coalitions of ecumenical groups in strengthening the role of caregivers for elderly and disabled people. The program's goal was to help the elderly live independently and avoid placement in a nursing home. Volunteers were trained and matched to an elderly person. They assisted in home-based services (such as preparing meals) and provided transportation and referrals to other community services. Twenty-five interfaith coalitions served urban, surburban, and rural communities. A report on the program, entitled Inter-faith Volunteer Caregivers: A Special Report and released in March 1989, reports that interfaith coalitions are a “viable approach to organizing caregiver volunteers to assist elderly and disabled people in their homes.” According to the report, approximately 58 percent of those served in the program lived alone, and less than 36 percent received care from a “formal agency.” In their first year of operation, each coalition recruited at least 140 volunteers and served 380 people. Total estimates of the people involved in the projects included some 900 congregations; more than 11,000 volunteers; and a total of 26,000 elderly and disabled people who were helped by the project's services. The projects were located in seventeen states, the District of Columbia, and the territory of Guam.Data on the IVCP projects were collected by the National Program Office at Benedictine Hospital in Kingston, New York. The Third Age Center at Fordham University in New York assessed the program. The Robert Wood Johnson Foundation contributed $3.75 million to the program.Because of the program's success, the National Federation of Interfaith Volunteer Caregivers was created in 1987 and received a two-year, $200,000 grant from The Pew Charitable Trusts. In January 1989, the federation received a $68,000 grant from the Public Welfare Foundation to identify up to thirty new projects nationwide that would be eligible to receive funding for start-up expenses from the foundation.Copies of Interfaith Volunteer Caregivers: A Special Report are available free from the Communications Office of The Robert Wood Johnson Foundation, PO. Box 2316, Princeton, NJ 08543-2316. Prenatal/Early Infancy Project , a ten-year study conducted in Elmira, New York, tracked the effects of periodic nurse visits on 350 young mothers, 85 percent of whom were poor, unmarried, or younger than age nineteen. Findings from the study were reported in “Improving the Life Course Development of Socially Disadvantaged Mothers: A Randomized Trial of Nurse Home Visitation,” American Journal of Public Health (November 1988): 1436-1445. The report was based on interviews that compared women who received periodic nurse visits to those in a control group who received fewer nurse visits or none at all. The study found that young women who received periodic nurse visits provided better care to their children than women who did not receive as many nurse visits.According to David Olds, a William T. Grant Foundation Faculty Scholar and principal administrator of the project, “Our preliminary results indicate less need for foster care, child-protection services, and welfare payments; and lower Medicaid cost associated with hospitalizations, emergency room visits, and subsequent pregnancies. In the long term, of course, the goal is to stop the vicious cycle of social disadvantage these mothers and their children now face in our society.”Based on the success of the project, a six-year replication project entitled “The Study of Nurse Home Visitation for Mothers and Children” is being conducted in Memphis, Tennessee. The project has 1,500 participants, a large proportion of them young black women, in an urban environment. Olds will administer the program.The Memphis project has received $6.3 million in support from The National Center for Nursing Research, The Carnegie Corporation of New York, The William T. Grant Foundation, The Robert Wood Johnson Foundation, The Pew Charitable Trusts, and other private and public sources.The Prenatal/Early Infancy Project in Elmira, New York received $240,836 from The William T. Grant Foundation, $706,253 from The Robert Wood Johnson Foundation, and $251,500 from the Ford Foundation. For more information, contact: David Olds, Box 777, Department of Pediatrics, University of Rochester, 601 Elmwood Avenue, Rochester, NY 14642.The Special Commission on Infant Health was formed in 1986 by the New Haven Foundation and the City of New Haven, Connecticut, in response to the alarming rate of infant mortality and low birthweight in the New Haven area. “One out of every 59 babies born in New Haven dies within the first year of life. Of every 38 non-white babies born to city residents in 1986, one died,” according to a report released by the commission. This report, entitled Better Beginning in New Haven
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