Addressing Critical Concerns of Healthcare Systems Serving American Indians/Alaska Natives

Private Sector Resources

Presenters: M. Katherine Kraft, Ph.D., Program Officer, Research and Evaluation Unit, Robert Wood Johnson Foundation, Princeton, NJ. Marsha Lillie-Blanton, Dr.P.H., Vice President, Health Policy, The Henry J. Kaiser Family Foundation, Washington, DC.

Robert Wood Johnson Foundation

The Robert Wood Johnson Foundation (RWJF) is the largest U.S. foundation devoted to health and healthcare. It is split into two program development groups, each of which has teams with specific grantmaking goals.

The Health Care Group is composed of:

• Coverage Team includes such efforts as Covering Kids.
• Priority Populations Team has the goals of improving access for vulnerable populations and addressing racial/ethnic health disparities.
• Clinical Care Management Team focuses on developing ways to integrate evidence-based medicine into physician practices.
• Supportive Services Team focuses on ways to help people with chronic illnesses and frail elders remain in their communities.
• End of Life Team strives to improve palliative care.
• Information Team focuses on determining the types of information needed by policymakers and includes the Health Tracking Study.

The Health Group focuses on the social determinants of health:

• Tobacco Team is currently seeking American Indians/Alaska Natives (AI/AN) entities for tobacco-related efforts.
• Alcohol and Illegal Drugs Team includes the Healthy Nations Initiative.
• Health and Behavior Team takes an ecological approach to health and wellness, rather than focusing on individual behaviors. It will initially target programs serving elders.
• Community Health Team considers community and social factors in promoting health and preventing isolation.
• Population Health Sciences Team seeks to create new tools for thinking about population health issues.

RWJF provides funds in two ways:

• Pools of money are outsourced to experts to distribute. For example, the Healthy Nations Initiative was outsourced to the University of Colorado Health Science Center.
• Some unsolicited proposals coming directly to RWJF are funded particularly if they are very strong proposals in groundbreaking areas.

Katherine Kraft made a number of suggestions for Indian health systems seeking to partner with this or other foundations:

• To make initial contact, send an e-mail or letter with a brief description of the idea.
• Do your homework by showing how your idea fits into the established health field and the larger context, as well as how it will "change the world."
• Relate your idea to the foundation's strategic focus, goals, and objectives. For example, RWJF is concerned with its grants showing a significant impact. Therefore, report why you believe your initiative will have an impact in the larger community.
• Outline the logic underlying the program design. What evidence or sound thinking supports the assumption that the program will work?
• Be honest about challenges to the program's success in order to build trust.
• Keep in mind that "less is more." With stacks of proposals to read, foundation staff are likely to look more favorably on a 7-10 page proposal than a larger one.
• Think of yourself as a partner to the foundation; you both need each other to successfully do your jobs.

Henry J. Kaiser Family Foundation

The Henry J. Kaiser Family Foundation is much smaller than RWJF (granting approximately $30 million annually) and functions as an operating foundation rather than a grantmaking foundation. Major program areas are: Health Policy, Media and Public Education, and Health and Development in South Africa.

The Health Policy area contracts with and provides grant support to a wide variety of organizations (or "strategic partners"). Activities include policy research/analysis and educating health policy leadership. Program areas include:

• The Kaiser Commission on Medicaid and the Uninsured.
• The Medicare Policy Project.
• The Changing Health Care Marketplace.
• HIV Policy.
• Women's Health Policy.
• Racial and Ethnic Minority Health.
• California Health Policy (which is the only segment that will consider unsolicited proposals).

The Native American Health Policy Initiative, part of the Racial and Ethnic Minority Health focus, has two components:

• Policy Fellowship Program for midcareer professionals, administered by First Nations Development Institute (an AI/AN economic development and policy organization), is moving into its third year. Fellows spend a year in Washington to learn Federal health policy issues and to present AI/AN issues to members of Congress; each receives a $40,000 stipend. In its first 2 years, five Fellows have participated.
• Policy research efforts include analyses of the Reauthorization of the Indian Health Care Improvement Act, Medicaid, Medicaid managed care, and financing AI/AN healthcare. One finding from these efforts is that there is an approximate 45-percent difference between the estimated per capita personal healthcare expenditures of the U.S. population as a whole ($3,619 in 1998) and AI/AN populations ($2,097 in 1998); Dr. Lillie-Blanton stressed that disparities in health status are caused in part by disparities in healthcare financing.

References

Compendium of grant resources for Native American elders programs: profiles of funders, resource agencies, internet resources. Washington (DC): Administration on Aging, U.S. Department of Human and Human Services; 1998.

Collaborating with government agencies: findings from the Grantmakers in Health Resource Center. Washington (DC): Grantmakers in Health; 2000 Feb.

Strategies for shaping public policy: findings from the Grantmakers in Health Resource Center. Washington (DC): Grantmakers in Health; 2000.

Williams MV, Brelvi SS. A closer look: profiling foundations created by health care conversions. Health Aff 2000 March/April;19(2):257-9.

Current as of August 2000

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Internet Citation:

Addressing Critical Concerns of Healthcare Systems Serving American Indians/Alaska Natives. August 2000. Workshop Brief, User Liaison Program. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/ulp/tribal/ulptribal.htm

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