Future Grantmaking Directionof the

Obici Healthcare FoundationMichael Beachler

First Obici Healthcare Foundation Grantee Meeting

Suffolk VA

March 19, 2008

Our Grantmaking Journey In 2007

• Start-up Year - first few grantees in Spring 2007

• April 2007-First Call for Proposals = 30 grants in October 07

• Community Health Assessment - Data Analysis Plus Interviews of Health and Community Leaders

• Planning Process with Foundation Board

Decision to Focus Our Grantmaking

Why Focus?

• To Achieve Greater Impact

• Maximize Available Resources to Attack the Problem(s)

• Greater Opportunity for Synergy Among Projects

• Permits Acquisition of Expertise

Criteria We Considered in Selection of Priority Areas

• Consistent with Mission and History of the Foundation

• Potential to Make a Difference on a Significant Problem

• Perspectives of Health Professionals and Community Leaders Responding to Survey

• Ability to Leverage Resources- Some Key Leverage Points at Community Level

Increasing Basic Health Care for the Medically Indigent

Priority #1

• Primary care - including dental, pharmaceutical assistance and maternal and child health/family planning

• Focus on Medicaid, FAMIS and uninsured populations

Summary of Financial Barriers in the Foundation’s Service Area

0

5000

10000

15000

20000

25000

Uninsured inregion

Adults notseeing doctor

due to cost

Adults withoutdental visitsprevious 2

years

Other Significant Access-Related Barriers

• From 2000-4,Infant Death Rate Higher in than the statewide average in every locality except Isle of Wight

• Teenage pregnancy rates were above state average in most locales (e.g. Franklin 60.1/ 1000 vs. VA. Rate of 26.5/1000

• Almost Entire Service Area is a Health Professional Shortage Area

Multifaceted Approach

• Strengthen Safety Net Providers

• Supply and Distribution of Providers

• Sociocultural and other barriers to care (e.g. patient literacy and linguistic barriers)

• Open to public education and advocacy efforts regarding state policy

Obesity in our Service AreaPriority #2

• Second to Smoking as a Cause of Death

• An Epidemic in our Service Area and Country

• An Estimated 73,000+ Adults in our Virginia

Service Area Overweight or Obese

• Childhood Overweight/Obesity Rates also High

Adult Overweight, Obesity, Exercise and Nutrition Estimates

*All Percentages from 2005

01020304050607080

Overweightor obese

No exercisepast 30 days

<5 servingsfruits/veg

VirginiaServiceRegionVirginia

Top Local Health Concerns fromCommunity Survey

Overweight, Obesity, & Nutrition was the most frequently named top local health concern in the Virginia Service Region

10

11

14

17

17

18

20

21

22

25

30

46

0 5 10 15 20 25 30 35 40 45 50

Health Education & Health Promotion

Adequate Health Provider Workforce

Sexually Transmitted Diseases

Mental Health and Mental Disorders

Access to Quality Health Services

Oral Health

Substance Abuse

Cancer

Physical Activity and Fitness

Diabetes

Heart Disease and Stroke

Overweight, Obesity, Nutrition

Immediate and Significant Health Concerns from Community Survey

Overweight, Obesity, & Nutrition was the most frequently named ‘immediate significant local health concern’ in the Virginia Service Region.

29

33

35

37

38

38

38

39

41

45

46

46

47

50

61

0 10 20 30 40 50 60 70

Family Planning

Health Education & Health Promotion

Infant/Child Health & Development

Injury & Violence Prevention

Tobacco Use

Sexually Transmitted Diseases

Oral Health

Access to Quality Health Services

Mental Health and Mental Disorders

Cancer

Substance Abuse

Diabetes

Physical Activity and Fitness

Heart Disease and Stroke

Overweight, Obesity, Nutrition

Multifaceted Approach That Will Evolve Incrementally

• Promote Walking and Recreation through Walking trails, thru Smart Community Design—Highly Leveraged Partnerships with Public Sector

• Establish Higher Nutritional Standards and Opportunity for Physical Activity in Service Area Schools

• Provide Low-Cost Access to Exercise and Weight Control Programs

Multifaceted Approach to Obesity

• Increase the Marketing and Availability of Healthy Foods to Low Income Individuals

• Promote Workplace Wellness - Highly Leveraged

• Work with Local Media to Educate the Public on these Issues

Vulnerable Populations

• Fund to lesser degree

• Projects serving individuals with substance abuse problems: alcohol, drug and tobacco

• Behavioral health problems

• Families affected by Homelessness, Child Abuse or Domestic Violence

• Vulnerable Services RFP-likely in 2009

Closing Thoughts

• Anticipate Staying with Priority Areas for a Number of Years- Increases the Opportunity to Make a Difference

• Will Try to Avoid Program Change for its own Sake

• Will Probably Make Some Mid-Course Corrections - Need to Maintain Some Level of Flexibility as Opportunities and Challenges Emerge