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The Casey Foundation's Investment in Health
Our vision: All kids and families in Casey Neighborhoods regardless of race, class and culture will be healthy and well so they can actively participate in the worlds of school, work and their community. Good health is a key determinant for family economic success, for healthy children ready to succeed in school, and an engaged citizenry. Good health enables parents to work and care for their children, and makes it possible for children to attend school and develop to their full potential. Moreover, good health is the cornerstone of strong and resilient communities. At the Casey Foundation, we believe that all families and children should have access to culturally effective health and mental health care services and live in supportive environments that maximize their wellness and productivity. Our investments promote effective neighborhood-based, high quality, culturally effective private and public health care. We promote comprehensive system reforms to improve the efficiency and quality of health care delivery. Both strategies, we believe, will contribute to a measurable reduction in racial health disparities These strategies are grounded in our firm belief that improving health outcomes for poor families and families of color requires that they become meaningfully involved in setting priorities, identifying interventions, and monitoring their effectiveness. We believe that much of health care and public health services should be designed and delivered at the community level, rather than in distant bureaucracies. In this way services are more effective because they reflect the cultural understanding and needs of the families they serve. Informed, organized, and empowered citizens can be among the most effective agents of change for better health care. With respect to health and health care, place clearly matters. For example, poor people of color are most likely to be forced into communities comprised of poor housing stock because of limited rental choices or sub-prime home loans. These neighborhoods typically lack public transportation to attend jobs or receive health care outside their neighborhood. A lack of health insurance and limited access to culturally effective health care exacerbated by chronic exposure to a wide range of social, economic and environmental stressors means that the residents of these communities are far more likely to experience worse health outcomes than their white counterparts. Given the complexity of racial health disparities, the Annie E. Casey Foundation’s agenda to reduce this gap is best understood within the Foundation’s overall focus on transforming tough neighborhoods into healthy environments where families can succeed. We recognize that medical care alone is not likely to significantly close the gap in health disparities or significantly improve the health of low-income families. But, we believe that when access to high quality, culturally effective health and public health care is placed within the larger context of our Making Connections initiative and its family strengthening agenda (or other community change initiatives), we may in fact improve the health and wellness of families and children of color. Casey Funding in Action Neighborhood Models - Through a series of grants to Kingsley House in New Orleans, we are supporting the expansion of a community outreach effort called Health Care For All, which recruits and trains community residents to conduct household health surveys, enroll families in Medicaid and LaCHIP, obtain food stamps and link them to the care they need. Since 1999, Health Care For All has enrolled 4,077 children and adults in Louisiana’s child health insurance program. This has translated into health care benefits totaling over $13.2 million as well as better protection from medical debt. Post-Katrina, this program visited 1,091 households, conducted 1,101 community assessments, and made 631 referrals for other services between January 2006 and July 2006.
- Through a series of grants in San Diego, we supported the development and implementation of Families Together, a Healthy Families USA model targeting East African refugee families and their children. This program, created through a refugee serving organization, Horn of Africa, has resulted in African immigrant infants and children meeting their developmental milestones, immunization targets and linked to medical homes. Partners in this effort include SAY San Diego, Universityof California San Diego, the local WIC program, Midcity Community Health Center and Scripps Wellness Center.
- In Boston, San Diego and the District of Columbia, we provided a series of grants to create community-based, culturally specific interventions to educate, screen, test and treat immigrants with latent tuberculosis infection. Treatment acceptance and completion rates range from 80% to 90%.
- In Cambridge, MA; Richmond, Va; San Diego, CA; and the District of Columbia, we are supporting new models—using home visiting, social networks, and peer supports-- for addressing the mental health needs of low-income and immigrant mothers of young children. Results indicate that these are highly effective and durable strategies across diverse cultures for reducing maternal depression and promoting the healthy developmental progress of their young children.
Neighborhood Systems of Care - Since 1994, the Foundation has provided a range of program and capacity building grants and technical assistance to enable residents in the East District of Richmond Virginia to create the East End Partnership with Families (EEPF). The Partnership now comprises 10 government agencies and community-based organizations all co-located in the East District neighborhood and linked with a web-based client tracking system that allows for full and comprehensive assessment of and quality assurance for residents seeking care from any one of the programs participating in the Partnership. Our grants also helped obtain approval for a federally funded community health center that now provides dental and mental health services in addition to primary care. A core provider is the Family Resource Center, designed and managed by a community board and provides a wide range of family supports: a food and clothing bank, computer training, a volunteer program, a seniors program, child care. Both the health center and FRC are leased from the city of Richmond for $1 a year each.
Policy Reforms - Since 1996, the Foundation has provided annual grants to the Center for Health Care Strategies. The Center, launched in 1995 by the Robert Wood Johnson Foundation, is the country’s leading resource for all aspects of Medicaid managed care, from design to implementation and to quality assurance. With Casey support, the center is active in health care quality improvement initiatives in 45 states. Through its Best Clinical and Administrative Practices (BCAP) initiative the Center has designed high quality strategies and interventions involving 134 health plans, 5 primary care case management practices and 13 other health organizations to deliver high quality care through the practices that has touched 53 million Medicaid beneficiaries. Examples include: reducing unnecessary hospitalization and emergency room use for asthma, improving preventive services for children, improving and increasing early screening and care for children with special needs, improving care for racially diverse populations, and improving birth outcomes for Medicaid clients. In addition, CHCS has conducted Purchasing Institutes impacting 43 states so they can improve the quality of the care they purchase with Medicaid managed care organizations. Overall, CHCS is active in 45 states around the country.
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