Steven Dawson of PHI addresses the briefing on direct care workers held recently by Philanthropy New York.
The health of any given community is fragile and complex. It is greater than the sum of individual health outcomes or access to care. The health of a community rests upon an infrastructure that meets the changing demands and needs of its people within constrained resources. Increasingly, our infrastructure needs to address employment, economic stability, and rising health care costs.
This is especially true given the sea change occurring, with 10,000 people turning age 65 each day in the United States. The maturing of the boomers is fundamentally shifting our view of what a healthy community looks like.
For 20 years, the Hartford Centers of Excellence (CoE) in Geriatric Medicine have been supporting the development of geriatrician faculty at schools of medicine across the country. These scholars have become researchers, educators, and clinicians, helping transform academic medicine to better prepare the next generation of physicians to care for older adults.
As we forge ahead with our new strategic plan to rapidly change health care practice to improve the health of older adults, our funding for the Centers is winding down. We are now intent on helping current CoE scholars and alumni, in addition to our academic superstars in nursing and social work, utilize their geriatrics expertise to change health care delivery for the benefit of older adults. We believe this is best achieved by helping them to connect and collaborate.
We are pleased that many of our existing grants are aiding in this transition. Funds within the CoE program, administered by our grantee the American Federation for Aging Research (AFAR), have been repurposed to bring together CoE Scholars and support their work to improve care for older adults. In doing so, we are offering five $40,000 grants to fund collaborative pilot projects.
In the world of philanthropy, there are only a handful of foundations focusing on aging and even fewer on aging and health issues.
Five years ago, The SCAN Foundation—an independent private foundation created by, but independent of, The SCAN Health Plan in Long Beach, Calif.,—was born. Over the years, they have been excellent colleagues, co-leaders in Grantmakers in Aging (GIA) and occasional partners on projects. In 2013, the John A. Hartford Foundation and The SCAN Foundation together cofunded an $800,000 grant to the National Committee for Quality Assurance (NCQA) to take on a major challenge: to help develop measures of quality of care for frail and disadvantaged elders that would be based on personalized goals of care and preferences.
In December 2013, Bruce Chernof, MD, president and CEO of The SCAN Foundation, spoke to the Hartford Foundation board about SCAN’s new five-year strategic plan, long-term care reform, and our deepening partnership. We look forward to working with Dr. Chernof and our other colleagues at SCAN over the next five years and beyond.
Last year, I was concerned and puzzled by what looked like continuing and consistent declines in first-year geriatric fellows in Internal Medicine (IM) and Family Medicine (FM) based programs, despite improving financial incentives. This year, there is an abrupt improvement, with first-year fellows in IM and FM rising by almost 20 percent.
Ok. We did it. We collectively put Chris Langston’s “What-if-we-have-a-party-and nobody-shows” fears to bed.
We had hoped for 200 attendees at our launch of the Change AGEnts Initiative at the Gerontological Society of America’s (GSA) annual meeting last month. Huzzah! Close to 400 Change AGEnts showed and actively participated in the interactive activities designed to inspire conversation and connections.
In case the launch or the AGEnts initiative has been off your radar:
In health care for older adults (and for everyone really), we know where we want to end up.
It gets articulated in different ways, but generally speaking I think we can all agree we want care for our older loved ones that is coordinated, comprehensive, continuous, and geriatrically expert.
But the path that gets us to that destination is often unclear. To help guide us—the John A. Hartford Foundation and all other stakeholders in the business of health care—we have just funded three grant projects that we hope will shine a light on the way forward.
As part of our Tools You Can Use series, we like to feature new products and resources that improve the health of older Americans. In this installment, two researchers share a free toolkit that provides evidence-based resources for staff in senior living communities promoting non-pharmacologic strategies to address behavioral and psychological symptoms of dementia.
The toolkit, presented by Ann Kolanowski, PhD, RN, the Elouise Ross Eberly Professor and director of the Hartford Center of Geriatric Nursing Excellence, College of Nursing, Penn State, and Kimberly Van Haitsma, Ph.D., a Clinical Health Psychologist with a specialization in geriatrics at the Polisher Research Institute, addresses a huge problem.
More than 5 million Americans are living with Alzheimer’s disease, with the direct costs of their care in 2012 totaling $200 billion, including $140 billion in costs to Medicare and Medicaid, according to the Alzheimer’s Association. The burden of care to family and formal caregivers is equally troubling: 90 percent of people with dementia will hit, scream, become verbally abusive, or resist care at some point.
If our shift in strategy moves our focus from “upstream” academic capacity building to a “downstream” emphasis on the determinants of practice, these vanguard leaders are shooting the rapids and teaching us what can be done with geriatric expertise.
Over the past several weeks, we’ve been introducing the John A. Hartford Foundation’s new funding areas and we’ve been highlighting examples of people and projects that exemplify the work we want to support under each strategy. Last week, Wally Patawaran discussed our Tools and Measures program area, which will support the improvement and advancement of quality measurement and information technology that can drive improvements in clinical practice and patient outcomes.
Today, we are sharing an interview with Dr. Aanand Naik, a geriatrician and a health services investigator at the DeBakey VA Medical Center in Houston and associate professor of medicine at Baylor College of Medicine. Dr. Naik was a Hartford Health Outcomes Research Scholar and affiliated with our Center of Excellence in Geriatric Medicine at Baylor.
As somebody who actually enjoyed studying statistics and quality improvement, the focus of the new funding portfolio I oversee—Tools and Measures for Quality Care—sets my pulse racing.
But I’ve been around enough to know my enthusiasm for constructing statistical measures of performance isn’t universal and that the greater good would be served if I explained our goals and why this initiative means a lot to all of us, whether we’re patients, caregivers, providers, payers, policy wonks, or other stakeholders.