Health Care Foundation of Greater Kansas City Program/Grants Committee Minutes of Meeting Tuesday, May 12 th, 2015 at 8:00 a.m. Location: Pioneer Campus of Penn Valley Community College 2700 East 18 th Street, Suite 211 Kansas City, Missouri 4127 Committee Members in attendance: S. Marie McCarther, Ed.D, Chair (participated via teleconference) Marshaun Butler Alan Flory Garland Land Ann Mesle (participated via teleconference) Juan Rangel Donna Valponi Committee Members unable to attend: James Nunnelly HCF Board Members and Associates in attendance: Tom Cranshaw, HCF Board Member Bridget McCandless, M.D., President/CEO Rhonda Holman, Vice President/COO Donna Bushur, Program Officer Brenda Calvin, Program Officer Graciela Couchonnal, Ph.D., Program Officer Andres Dominguez, Program Officer Karen C. Guile, Grants Manager Assistant Jessica Hembree, Program Officer Jane Mosley, Ph.D., Program Officer Adriana Pecina, Program Officer Tracy Skidgel, Executive Assistant/Office Manager Jennifer Sykes, Communications Officer Guests in attendance: Elizabeth Durkin - MOCSA Kim Flynn - Truman Medical Center Charitable Foundation Maggie Priesmeyer BikeWalk KC Anne Roberts - El Centro, Inc. Lori Smith, Palestine Senior Center Jenna Wilcox Mattie Rhodes Center Welcome Marie McCarther, Ed.D., Chair, called the meeting to order at 8:00 a.m. and thanked those present for attending. Dr. McCarther also welcomed the guests in attendance and asked them to introduce themselves. Approval of 2015 Healthy Communities Recommendations Brenda Calvin directed the Committee s attention to the Healthy Communities memo and reports included in the meeting packet. She explained the budget for the 2015 Healthy Communities RFP is $2.7 million. In February, HCF received 58 grant proposals for a total of approximately $7.1 million. The RFP
2 team leads are encouraged by the number of requests that were received this year. They are also very encouraged by the increase in integrated and multi-sectoral approaches and effective collaborations demonstrated in the proposals and glad to see alignment with the RFP. Ten (10) external reviewers met on April 10 th to come up with a slate of recommendations and instructions for HCF due diligence. HCF Associates recommend 22 grants totaling $2,400,000 as well as $300,000 to be used to continue Healthy Communities planning and field building within the HCF service area. Ms. Calvin reminded the Committee that the Board approved reserving $300,000 of last year s Healthy Lifestyles RFP to invest in capacity efforts, such as the 2014 Healthy Lifestyles Leadership Academy, and to support the Missouri Convergence Partnership. If approved, the $300,000 in technical assistance recommended for this year s RFP would continue to support these efforts. She directed the Committee s attention to a document included in the meeting packet regarding the Healthy Communities Leadership Academy which explains the Academy and its participants. Alan Flory made a motion to approve the $300,000 allocation of the Healthy Communities RFP for planning and field building within HCF s service area. Garland Land seconded the motion. The motion was approved by unanimous voice vote. Committee members were asked to complete their ballots for the Healthy Communities grant award recommendations. Chair McCarther reminded Committee members of the Conflict of Interest Chart at their tables and asked them to recuse themselves from voting if necessary. Tracy Skidgel tallied the ballots. Healthy Communities recommendations were approved as follows: Organization Name Yes No Abstain Recuse 1 After the Harvest 2 Black Health Care Coalition, Inc. 3 Communities Creating Opportunity (CCO) 4 2 4 Cultivate KC, Inc. (formerly KC Center for Urban Ag) 5 Developmental Disability Services of Jackson County EITAS El Centro, Inc. 7 Greater Kansas City LINC, Inc. 5 1 8 Hartwig Legacy Foundation dba- KC Healthy Kids 9 Harvesters - The Community Food Network 5 1 10 Ivanhoe Neighborhood Council 11 Jewish Vocational Services 5 1 12 Kansas City Community Gardens, Inc. 13 Kansas City Food Hub (Charitable Arm of Good Natured Family Farms) 14 KU Endowment Association 15 Lafayette County Health Department 1 Niles Home for Children 17 Palestine Senior Citizens Activity Center, Inc. 18 restart, Inc. 5 1 19 Rosedale Development Association, Inc. 20 The Children s Mercy Hospital 4 2 21 Unified Government of Wyandotte County Public 2
3 Organization Name Yes No Abstain Recuse Health Department 22 Upper Room, Inc. Approval of Special Initiative Recommendations: Recommendation to Approve the Missouri HealthNet, Community Health Worker (CHW)Pilot for Primary Care Health Homes Graciela Couchonnal, Ph.D. directed the Committee s attention to the explanation of this initiative recommendation included in the meeting packet, which was also sent to the Committee in advance of the meeting. She provided some background information regarding the events and previous funding that preceded this initiative recommendation. She explained that HCF, in partnership with Missouri Foundation for Health (MFH), will provide funds to cover a portion of the cost (55%) of hiring Community Health Workers (CHWs) for several clinics participating in MO HealthNet s Health Home Program. The CHWs will provide care coordination services to patients who are high utilizers (patients having three or more emergency department or two or more hospitalizations within the past 12 months). Funding from HCF and MFH will support the initial implementation of the project in East, West and Southwest regions of the State and will generate the data required to scale this program to the entire State of Missouri. Furthermore, this grant will evaluate the impact that Community Health Workers can have on improving the health of high utilizers and thus reducing unnecessary use of health care services including emergency room visits. HCF would be collaborating with Missouri Foundation for Health, MO HealthNet, the Missouri Department of Health and Senior Services, and Caring Community to implement this initiative. HCF funding of up to $380,000.00 over two years would help to provide salary support for seven (7) community health workers to serve health homes in the Kansas City area which have a high percentage of patients who are considered high- utilizers. Dr. McCarther thanked Dr. Couchonnal for her explanation of the initiative recommendation. She then asked Committee members to complete the ballots before them and recuse themselves when necessary. Tracy Skidgel tallied the ballots. The Special Initiatives were approved as follows: Initiative Yes No Abstain Recuse 1 MO HealthNet Community Health Worker Pilot for Primary Care Health Homes High Impact Special Initiative Data Follow-Up Rhonda Holman provided a recap as to what prompted these serial discussions at Program/Grants Committee meetings regarding a high impact initiative. She reminded the Committee that, following the data presentation by Dr. Saint Onge at the last meeting, the group requested to see more data regarding trend information and to take a deeper dive into the data according to racial and ethnic categories. She then welcomed Dr. Jarron Saint Onge to provide a brief presentation. Dr. Saint Onge presented the data he was able to find regarding trends (over ten years). The data-driven target areas included: COPD, pneumonia, congestive heart failure (including circulatory, heart disease, hypertension), diabetes, childhood asthma, low birth weight (IMR), stroke, and mood disorders. Dr. Saint Onge found that most preventable hospitalizations (pneumonia, COPD and circulatory issues make up 5%) are down trending over time. 3
4 Exceptions to the downtrend include: both COPD and pneumonia trends are increasing in Allen County, COPD is also increasing in Wyandotte County, and both COPD and childhood asthma are increasing in Jackson County. In regards to how the trends play out within race and ethnicity, Dr. Saint Onge stated that there are some disparities of childhood asthma and diabetes within Hispanic and non-hispanic Black populations in Jackson, Wyandotte and Johnson Counties. There were also disparities within non-hispanic White populations in both Cass and Wyandotte in the areas of mood disorders and alcohol abuse, and some issues with hypertension and circulatory problems in non-hispanic Blacks in Jackson County. Dr. Saint Onge cautioned the Committee regarding the limitations and future challenges regarding this sort of data collection, such as: measurement inconsistencies data regarding racial disparities requires counties with large minority populations mental health data is limited to self-reports/hospital discharges child data is limited analyzing data regarding trend and race/ethnicity stretches the data very thin prioritization of the data is difficult because, while there are lots of problems, there is no clear outlier to indicate one significant problem within HCF s service area there are many variables that lead to the target areas on which we focused (i.e. there is not just one clear cause of the diseases targeted) Ms. Holman stated that she felt they had traveled as far as they could using a global datadriven approach; however, no single issue arises from the data on which we could focus. The next step for the Committee is to determine how to prioritize the health condition(s) in which the Foundation is interested in targeting. Ms. Holman distributed a handout that listed the health conditions and behaviors to which the data points and asked the Committee to take the list home to ponder. In July, the Committee will be asked to undergo a voting process to select 3 problems for which more research will be conducted, such as an investigation into the literature regarding successful approaches to reducing the diseases in other communities. In the interim, Ms. Holman asked the Committee Members to consider the conditions on the handout that was distributed and think through three (3) issues they feel are a major need in our community. It is understood that the Committee will need to come to terms with how we define impact (i.e. is impact creating sustainability within a smaller community to deal with a problem, or is it strictly the number of people served, or etc.) Dr. McCarther thanked Dr. Saint Onge for his presentation. Report of March & April 2015 CEO-Approved ADGs Adriana Pecina directed the Committee s attention to the ADG reports and graphs included in the meeting packets. In March and April combined, HCF Program Officers reviewed twenty (20) ADG applications totaling approximately $1.1 million in requested funds. Fourteen (14) grants were approved, totaling $710,454; one (1) application was declined; and five (5) of the requests reviewed were pended until the next month. Dr. McCandless explained for the benefit of new Committee members that Applicant Defined Grants may be awarded up to $75,000, are approved by the CEO, and are reviewed on a monthly basis. Safety Net Health Care 2015 RFP Announcement & Approval of 2015 Safety Net Technical Assistance Funds Andres Dominguez directed the Committee s attention to the draft of the 2014 Safety Net Health Care RFP included in their meeting packet. Mr. Dominguez stated that the RFP is very similar to the previous year and again focuses on access, quality and cost. A pre-proposal conference is being held for this RFP on May 14 th at 4
5 the Kauffman Foundation from 8:30am to 11:30am. Dr. Sarah Martin Anderson, professor of Health Administration at UMKC, will be providing a presentation at the conference regarding social determinants and the safety net neighborhood. The deadline for Letters of Intent (LOIs) submission for this RFP will be June 24 th, and full proposals will be due on August 5 th. The Board will vote on a slate of grant recommendations for this RFP in December. Dr. Couchonnal explained that the Foundation would be accepting two-year grant requests for the 2015 Safety Net RFP and HCF Associates would like to request approval to change the current method used by HCF to book grant payables for multi-year grants. She directed the Committee s attention to a handout that provides an explanation of this request. The current policy for booking multi-year grant awards is to take all years of the multi-year grant out of the current year s budget. However, awarding many multi-year grants at a time eats up money reserved for the RFP, which has made it difficult for HCF to award many multi-year grants for the Safety Net grant round in the past. HCF Associates propose that we alter the policy and pay the second year of the two-year grants out of the next year s budget. For example, the budget for 2015 Safety Net FDG grantmaking is $4.0 million; under the recommended revised policy, $4.0 million in Safety Net grants will be booked in 2015, and all dollars awarded for the second year will be obligated in the 201 budget; so, theoretically, we could have fewer dollars to give out in 201. Under this new policy, grant agreements with multi-year awardees will need to stipulate that the second year of funding is contingent upon performance and it may be necessary to alter some areas of the internal grantmaking process, such as the reporting schedule (e.g. request an interim report later than the normal six months in order to provide more time for multi-year grantees to show outcomes from their first year of funding.) Alan Flory made a motion to approve altering the payment structure of multi-year grants. Juan Rangel, Jr. seconded the motion. The motion was approved by unanimous voice vote. Brief Updates President/CEO Dr. McCandless informed the group that program officer Mary Kettlewell was progressing in her disease and had entered hospice care. She asked that they keep Mary in their thoughts. She updated the Committee that the 10-year celebration picnic was a success and a wonderful way to thank our grantees for the work that they do. Dr. McCandless also updated the Committee that the Kansas Grantmakers in Health (KGIH) Opportunity Fund, to which HCF contributes approximately $50,000 annually, was able to leverage $3 million federal dollars to enhance Federally Qualified Health Centers through increased access points. Mental Health RFP Donna Bushur reported that the Foundation was midway through its process of reviewing Mental Health proposals. External Reviewers were currently reviewing 54 proposals totaling $8.7 million and will be meeting in June to determine a slate of recommendations for funding. The slate of recommendations will be presented to the Program/Grants Committee in July. There is $4.3 million budgeted for the 2015 Mental Health RFP. Evaluation Update - Dr. Mosley stated that there was nothing new to report at this time. Advocacy Activities Jessica Hembree informed the Committee that there is a proposal in the Kansas legislature to increase the tobacco tax by $1.00 per pack. KU Cancer Center came out in support of the proposal and the feeling is that there is a good opportunity for the proposal to move forward. Ms. Hembree reported that the issue of Medicaid expansion has not made any progress in either Kansas or Missouri. On a positive note, the Missouri Coalition for Oral Health was able to lobby and persuade the legislature to pass a bill which creates $17 million in adult Medicaid oral health benefits in the state of Missouri. These dollars will leverage an additional $25 million in federal benefits. Also in Missouri, there are two tobacco tax measures being considered: one to 5
fund early childhood educational activities, the other focused on funding for higher education. HCF team has been meeting with both groups to better understand the efforts and the potential impact of the increased tax on youth smoking and on low income communities. We feel that, in order for HCF to support a campaign to increase the tobacco tax, it would need to have a clear public health benefit. Communications Jennifer Sykes updated the Committee that Associates and our consultants are still working hard on the 10-year project. We are working on finding a date and venue for a large luncheon to launch the 10-year report, for which Kathleen Sebelius will be the key note speaker. The new HCF website is coming along well. Also, HCF is having infographics developed for the KC Health Matters website for each county in our service area in order to demonstrate how the website was used to gain the data. We are also developing a webinar that talks about the KC Health Matters website and how to use the Best Practices section of the site. Chair McCarther thanked the Program Officers for their updates. Public Comments - None. Chair McCarther thanked everyone for their attendance and participation in the meeting. The meeting adjourned at 9:30am. The next meeting of the Program/Grants Committee will be July 14, 2015 at 8:00 a.m., 2700 East 18 th Street, Suite 211, Kansas City, MO 4127, 81.241.700.