Childhood Asthma Linkages in Missouri (CALM)

In Missouri, childhood asthma is the leading cause of emergency room visits, inpatient hospitalizations and school absenteeism among kids aged 15 years or younger. In 2007, Missouri Foundation for Health established CALM to demonstrate effective collaborations between schools, providers and community organizations, leading to evidence-based models and promising practices showing improved asthma care and health outcomes.

We partnered with 14 organizations throughout the state to integrate childhood asthma support into their daily operations. Funds went to collaborative and multifaceted program models led by community hospitals, school districts and university-affiliated health centers that utilize community-based approaches to build successful linkages among those responsible for asthma care in children.

Promising results from CALM include a 35 percent decrease in asthma-related school absenteeism. New policies that encourage communication between primary care providers, schools and parents, along with increased asthma education in schools are just a two of the many CALM-initiated changes that can be replicated elsewhere.

CALM was such a success that in 2014 grantees from the initiative helped the Missouri Asthma Prevention and Control Program garner a federal grant. A portion of those funds are going toward the creation of CALM2, a five-year statewide expansion of the CALM model.

Learn more by viewing our CALM infographic.

Cover Missouri Leads Way in Insuring Missourians

2014 marked the second year that consumers could enroll in Affordable Care Act health insurance plans. During the open enrollment period (November 15, 2014 – February 15, 2015) Missourians had the opportunity to sign up for quality, affordable health insurance through the state's Health Insurance Marketplace. Pressure was high to build upon the momentum from the previous year, during which more than 150,000 people in the state enrolled, exceeding federal projections by 29 percent.

As part of the Foundation's Expanding Coverage initiative, the Cover Missouri Coalition continued its statewide campaign to educate Missourians about the health insurance options available to them. Before and during the open enrollment period, Cover Missouri Coalition members hosted hundreds of free education and enrollment events, distributed informational materials on Marketplace plans and financial options, extended office hours, provided in-person support and answered questions via social media. As a result, enrollment numbers throughout the state increased by 67 percent over the previous year. As of early 2015, more than 253,000 Missourians were enrolled in Marketplace plans, with the state ranking ninth in total enrollees.

Here are some "Health Stories" highlights, from Missouri Health Care for All's website.

Learn more by visiting CoverMissouri.org or read the original release here.

Ferguson and Health Equity

After the tragic death of Michael Brown in Ferguson, Missouri in August 2014 and the unrest that followed, issues of health equity were put to the forefront at the Foundation. In truth, even before this nationwide wake-up call, MFH recognized health equity as one of the defining issues in our region.

In December 2014, as the region struggled to address the continued turmoil, the Foundation and five other philanthropic organizations joined forces to pledge a total of $150,000 to the Ferguson Commission. The funds were offered to assist the commission in fulfilling its broad charge of assessing the underlying social and economic conditions underscored by the events leading to and following Michael Brown's death.

Missouri Foundation for Health, Deaconess Foundation, Greater Saint Louis Community Foundation, Incarnate Word Foundation, Daughters of Charity Foundation of St. Louis and Lutheran Foundation of St. Louis all felt a moral obligation to be partners in finding solutions to various community concerns and ongoing issues.

The Ferguson Commission released its final report in September 2015, but the process to address these issues is only just beginning. The Foundation and other likeminded groups will continue to promote positive changes, dialogue and the closing of the health equity gap.

Learn more about the Ferguson Commission's findings by visiting their website.

Other health equity work from 2014:

• Older Adult Health Disparities publication
• For the Sake of All, a multi-disciplinary project studying African American health disparities in the St. Louis area (LINK)

MoCAP Helps Bring Millions of Funding Dollars to Missouri

2014 marked another successful year for the Foundation's MoCAP program, with a total $11.6 million awarded to Missouri-based nonprofits and governmental health organizations. MoCAP does not provide these funds directly, but helps organizations secure them by offering grant consultation and technical support to groups pursuing funding for health or prevention-focused programs. MoCAP services are provided at no cost to qualifying organizations. The goal of MoCAP is to assist groups in submitting stronger applications, resulting in them becoming more competitive on a national level.

"MoCAP is a unique project for us because in this case we are assisting organizations with capturing outside resources, rather than direct program funding," explained Foundation Health Policy Officer Jessi LaRose. LaRose coordinates assistance for an average of 50 applications per year from a variety of organizations. "We show local nonprofits, some of which have never applied for federal grants before, that it really is within their reach to compete for these national awards. Moving forward, they're much more likely to apply again."

Successful MoCAP participants from 2014 include the Saint Louis Mental Health Board, which gained funding through the Substance Abuse and Mental Health Services Administration to create a strategic plan to improve health care access for children with serious emotional disturbances and/or special needs. Betty Jean Kerr People's Health Center (St. Louis), Community Treatment Incorporated (Festus) and Family Care Health Centers (St. Louis) were all awarded grants from the Health Resources and Services Administration, with a goal of better integrating mental health services within existing health centers.

Of particular note is a MoCAP-assisted grant from the Centers for Disease Control to Missouri's Department of Health and Senior Services, for its Missouri Asthma Prevention and Control Program (MAPCP). MAPCP will create the Childhood Asthma Linkages in Missouri 2 (CALM2) program, a direct follow-up to CALM, a five-year initiative created by MFH in 2007. Implementation of the CALM2 program will include the identification of high-risk children with asthma and the coordination of primary care and home visits with health insurers and Medicaid. Click here to learn more about our original CALM initiative.

Since its inception MoCAP has supported over 250 proposals from a variety of different types of organizations, including community health centers, state health departments and local nonprofits. To date, for every dollar the Foundation has spent on MoCAP, $31 has been brought to the region.

For the Sake of All

In May 2014, months before the tragic events in Ferguson put issues of health equity in the spotlight, the multi-disciplinary project For the Sake of All completed the first phase of its work. The project, led by researchers from the Brown School at Washington University in St. Louis, studies health disparities in the African American community in St. Louis. The milestone was marked with a community conference and the release of a final report. Funded in part by MFH, the project aims to inform and engage the public about health inequity in the region.

In July 2014, MFH awarded an additional two-year grant to the project. These funds will help further the project's goals, with an emphasis on engaging policymakers, business leaders and other community members regarding the actionable findings from the 2014 report.

Learn more about For the Sake of All and read the full report by visiting forthesakeofall.org.

Other health equity work from 2014:

• Our work with the Ferguson Commission
• Older Adult Health Disparities publication

Reducing Readmissions, Improving Outcomes

High hospital readmission rates put a substantial financial burden on our health care system and illustrate the fact that patients are sometimes not provided the tools and support they need to stay healthy after discharge. For example, Medicare alone reportedly spends an average of $17.8 billion each year on avoidable hospital readmissions.

Through the work of the Responsive Portfolio and its Special Projects funding program, the Foundation is committed to improving the health of Missourians across the spectrum of health and health care.

In 2014, out of 23 approved Special Projects grantees, five different groups proposed plans to reduce hospital readmission rates and/or improve the quality of care their patients received. In its own way, each of these organizations is engaging in client-specific work that ensures that patients have the resources they need to keep them from returning to the hospital.

Memory Care Home Solutions (Saint Louis Metropolitan Region\St. Louis City) is working to help family caregivers of those with dementia. These family members are often at the front line of care, and yet they themselves often lack the necessary support and knowledge. Memory Care Home Solutions is utilizing in-home interventions that integrate social work and occupational therapy, with a plan to track outcomes over two years.

Cox Medical Center Branson (Southwest Region\Taney) in a partnership with Cox Monett Hospital, is striving to improve health outcomes at both of their respective emergency rooms. Through the utilization of new telemedicine technology, they are working to offer immediate lifesaving specialty care.

Bootheel Counseling Services (Southeast Region\Scott) is focusing on mental health services, noting that people living in rural areas often have inadequate access to mental health care and enter treatment later in life. This delay can lead to more serious, disabling symptoms that require more expensive and intensive treatment. The group is working to eliminate barriers and increase access to care by creating community partnerships and linking individuals to mental health providers.

Ozarks Medical Center (Southeast Region\Howell) is providing case management in the emergency department for a total of three years to high-utilizing patients with complex medical and/or social needs. Two full-time case managers are working with the emergency department team, the primary care community and other community resources, leading to successful outcomes as their patients are discharged from the hospital.

Older Adult Health Disparities

2014 marked the fourth publication in our Health Equity Series: Older Adult Health Disparities in Missouri. The comprehensive report details the many health concerns that Missouri faces as our population "grays" over the next few decades. The publication takes a broad look at the physical and mental health of older adults, along with recommendations related to policies and services to meet the needs of this growing demographic.

View the full report here.

Previous entries in the Health Equity Series researched disparities in African Americans, Hispanics and the LGBT population.

Coro Fellows Return

After completing a five-week session at Missouri Foundation for Health earlier in the program, two 2014 Coro Fellows opted to return to MFH for the final segment of their fellowship. From April 18 to May 8, 2015, Fellows Marina Balleria and Joseph Hassine rejoined the Foundation for their self-assigned individual placements.

MFH has been a supporter of the Coro Fellowship for more than a decade, often hosting fellows on site and providing them with direct experience in a foundation setting. The Foundation also periodically sponsors fellowship placements at other regional nonprofits. The fellowship gives participants hands-on public affairs experience in five different sectors: nonprofit, government, private, public and campaign.

At the heart of the Coro Fellowship is the development of well-rounded, well-informed public leaders. The program gives fellows a unique perspective as to how the community fits together and how the different sectors can influence and interact.

Learn more about the fellows and their experiences at the Foundation here.

Health and Housing, an Integral Combination

For many people, having safe, affordable housing is the foundation on which they can build healthy, productive lives. The opportunity to have a stable place to live, along with access to unified health care services, can make all the difference, particularly for individuals with disabilities and/or health conditions. In 2014, the Foundation launched the Show Me Healthy Housing program, which uses this philosophy of permanent supportive housing to help a variety of different populations in our service area build or rebuild secure lives for themselves.

The Show Me Healthy Housing pilot program began in the fall of 2014, working to partner with and provide gap financing to health-related nonprofits that are working to provide permanent supportive housing. Four initial partners were chosen: the Columbia Housing Authority (Patriot Place Apartments, Columbia), Preferred Family Healthcare (Chloe Place, Hannibal), North East Community Action Corporation (Berkshire Estates, Mexico) and The Kitchen (Beacon Village II, Springfield). Each partner organization is using its funding to aid in the construction of housing as well as the provision of case management and health care services for their clients.

"It's wonderful to see so many different organizations coming together for such an important cause," said Foundation Program Officer Jean Freeman-Crawford. "By offering supportive housing, you're combining housing with on-site services that may include counseling, case management, job training, health care screenings and other social services. By packaging these services together, we can really assist individuals in improving their health and overall wellbeing."

"Housing and the social determinants of health are critical MFH strategies," said Darin Preis, executive director of Central Missouri Community Action and member of the Foundation's board of directors. "When statewide funders, local businesses and investors all work together to make Missourians healthier we see impressive projects like this that could not be achieved by any one of them alone."

MFH Honors Dr. Plax With Leadership Award

In December of 2014, during the Foundation's annual dinner, Dr. Katie Plax accepted the Dr. Corinne Walentik Leadership in Health Award, which was created to honor the late Dr. Walentik's commitment to serving vulnerable populations. Plax was the second honoree of the award, with Walentik herself the posthumous recipient in 2013. The award is presented to a leader in Missouri health care who exemplifies the passion, dedication and energy that Walentik brought to her work.

Plax personally received $2,500, and was given the opportunity to donate $25,000 to a nonprofit organization of her choosing. She chose to gift the funds to The SPOT (Supporting Positive Opportunities with Teens), a nonprofit that she co-founded.

A native St. Louisan, Plax has devoted her career to improving the health of disadvantaged groups, particularly young people, through patient care, teaching, research and advocacy. Her career has spanned from working directly with high-risk adolescent patients, to teaching residents about how to best serve patients in poverty or with special needs, to advocating at the national level for policy change.

In 2008 Plax worked with a team of experts and social workers to create The SPOT in the city of St. Louis. Founded in part with funding from MFH and supported by Washington University, the organization offers underserved young people ages 13-24 a safe place to receive free health care, counseling, STD screenings, social support and more. Plax serves as The SPOT's medical director, while also working as a pediatrician and director of the Adolescent Center at St. Louis Children's Hospital. Additionally, she is the division director of adolescent medicine and an associate professor at Washington University.