Grant Making That Makes A Difference
Based on more than thirty years in funding health care grants, I’d like to share some of the lessons the Board, the Grant Committee and the staff at Washington Square Health Foundation (WSHF) have learned. As I look back on the types of grants, there are some categories that emerge:
Research and education,
Community health including nutrition,
Optimization of health care resources,
Public health challenges including infectious diseases,
Convening health care advocates and
Preventive health care services.
One of the educational grants funded a project to improve the quality of medical students’ primary care skills using surrogate patients. Standardized patient experiences allowed third year students to address both the physical and emotional signs and symptoms they would later experience in their clinical training and practice. The project accelerated the use of surrogate patients as a teaching tool in medical schools across the country.
For several consecutive years, WSHF has funded a pediatric Hematology/Oncology Research Fellowship through the Ann and Robert H. Lurie Children’s Hospital. Subsequent foundation sponsored reunions have allowed the fellows to share their research experiences and the significant impact they are having serving their communities clinically and as civic leaders.
WSHF became the first foundation in Chicago to provide funding for a nutritionist as part of holistic treatment for HIV/AIDS patients at Howard Brown Memorial Clinic. Recognizing the importance of nutrition and health, the foundation annually funds food pantries in the Chicago area.
In 1992, WSHF funded a study and conference on emergency room overcrowding in 11 different Chicago hospitals. The study revealed some of the root causes of overcrowding such as ineffective primary care delivery, inefficient hospital bed utilization, increases in violence and drugs, and cutbacks in human services. Contributing factors included nursing shortages, lack of disease prevention strategies, insufficient communication between ER and primary care providers and lack of public education regarding the health care delivery system. A subsequent national conference and report based on the study led to several improvements in patient flow through hospitals, ER and primary care provider clinics. Resources could be more effectively targeted to alleviate ER overcrowding and provide more appropriate care the right time in the appropriate setting.
WSHF was a pioneer in the utilization of Program Related Investments (PRIs) by small conversion health care foundations in Chicagoland area which provide low interest loans to non-profit organizations that otherwise may not qualify for a traditional commercial loans. An example if this type of funding is the support for accessing patients’ medical records across health care sites which has been greatly enhanced using electronic medical records. WSHF funded a PRI for an Electronic Health Records (HER) Implementation Project that purchased software connecting computers and phone systems for all the PCC health centers. PCC is a Federally Qualified Heath Center (FQHC) that provides health care in the underserved Austin neighborhood of Chicago.
In the late 1980’s, WSHF was one of the first foundations to funded direct service grants specific to patients with HIV/AIDS. Because of fear of transmission, many AIDS patients had difficulty accessing needed health care services and many foundations were “afraid to provide direct service grants to this population because of the then extreme negative bias towards persons with this decease, especially members of the gay and minority communities. With a grant to Ancilla System, Inc., a home care and hospice program was developed to provide direct, hands on care for HIV /AIDS patients. Washington Square funded as noted above, the first nutritionist as an adjunct therapy provider for HIV/AIDS patients in the Chicagoland area. In addition it was also instrumental in not only funding but in actually developing one of the first HIV housing facilities in Chicago, Bonaventure House.
The Foundation also lead the way in HIV/AIDS research through another grant which helped to develop a high-level containment virus laboratory at Northwestern Memorial Hospital. The laboratory’s purpose was to successfully isolate the HIV virus from blood and tissue samples and engage in HIV and retroviruses testing. The initial grant also led to $800,000 in federal funds to build the containment laboratory which is shared with other scientists and medical centers.
Additional ground breaking research was accomplished by working with a senior scientist from the Weizmann Institute in Israel and local medical centers, WSHF helped to fund an international collaborative project to develop a noninvasive means of determining if lesions found in a woman’s breast via mammography are malignant, without the use of biopsies ( 3TP methodology) . This method, using MRI imaging, which was approved by the FDA in 2003, results in a quicker, more cost-effective means of diagnosis while avoiding the potential trauma of breast biopsies.
Washington Square Health Foundation recently has sponsored in conjunction with the A Silver Lining Foundation a meeting of select Chicagoland health care institutional providers of MRI breast imagery to explore the possibility of a clinical trial of the next generation of utilization of MRI technology as a screening and diagnostic tool for breast cancer, without contrast, under the supervision of Dr Hadassa Degani, Pressor Emeritus , Weizmann institute of Science, Israel, the original creator of the 3TP MRI with contrast methodology as noted above allowing for a computerized program to read MRI breast imaging, without the need for biopsies. Her new innovation of the use of MRI , without contrast for evaluating MRI breast imaging will allow for safer and more wide spread use of this non-invasive and non- radiation based making technology.
Another international research collaborative is the Chicago Diabetes Project (CDP) to develop a functional cure for Type 1 diabetes mellitus. Initially based at UIC, this world-wide effort is utilizing the best and brightest scientists and clinicians in pancreatic islet cell proliferation and encapsulation research which are key to curing diabetes. WSHF acted as a catalyst for the pilot stages of the CPD and has continued to fund conferences that bring together the principle investigators.
An example of Washington Square’s leadership in local founder collaboration as well as increasing funding from national funding sources is as follows: The Illinois College of Optometry (ICO) provides eye care, free of charge, to indigent patients along with referrals for primary care providers. 65% of the patients suffer from systemic diseases such as diabetes and hypertension and need ongoing medical treatment. WSHF helped the ICO to receive a Robert Wood Johnson grant of over $500,000 for the eye care program and was the lead foundation in obtaining additional matching funding from several other local foundations. ICO now partners with over 35 social service and FQHC community health organizations in the Vision of Hope Health Alliance.
WSHF is more than a conduit to transfer dollars to fund grants. The Board, staff and consultants work with funding requests to develop projects that aim to transform health care through innovative research, improved patient care and advocacy, and better use of precious health care resources. What may began as a simple grant request can be amplified by convening stake-holders and involving additional resources. No single foundation can meet the needs of reforming and improving health care. However, local and national foundations can define and illuminate the pathway to trying to improve health care locally and nationally.
William N. Werner, M.D., M.P.H., F.A.C.P.