Project HEALTH: Mobilizing a Pipeline of New Leaders to Change Health Care Delivery Health Action 2010 Conference

2 Prerequisites to Positive Health Outcomes Social Determinants of Health Access to Care Quality of Care

3 Resource Needs in America 3 Food Resource Need Over 17 million Americans are eligible for but do not receive food stamps A substantial number of Americans qualify for but do not receive assistance across a number of resource needs Housing 6 million renter households in America receive no housing assistance and have severe rent burden and/or severely inadequate housing Energy 50-70% of households eligible for LIHEAP (Low Income Housing Energy Assistance Program) benefits in cold regions do not receive benefits Education Of the 194 million Americans over the age of 25, 14.3%, or 27.7 million, are without a high school education Employment / Income There are 46 million uninsured Americans and 37 million living below the Federal Poverty Line Sources State of the States: 2007 A Profile of Food & Nutrition Programs Across the Nation; Food Research and Action Center HUD (2005): Affordable housing needs report to Congress 2008 Annual Social Economic Supplement (2007 data) Digest of Education Statistics, 2007, US Department of Education Income, Poverty, & Health Insurance Coverage in the United States: 2007, US Census Bureau August 2008 Health Insurance Coverage of the Nonelderly by Poverty Level, 2007, Kaiser Commission on Medicaid and the Uninsured/Urban Institute Analysis of March 2008 CPS

4 Access to Resources Impacts Health Outcomes Children who experience food insecurity – uncertain or limited supplies of nutritious food – are 30% more likely to be hospitalized by age three. 2 Children less than 3 years old whose families need but do not receive help paying their gas or electric bills are 30% more likely to be hospitalized. 1 1 Frank, D., Neault, N., Skalicky, A., Cook, J., Wilson, J., Levenson, S., Meyers, A., Heeren, T., Cutts, D., Casey, P., Black, M., and Berkowitz, C. Heat or Eat: Low Income Home Energy Assistance Program and Nutritional Risk Among Children Under 3 Years Old. Pediatrics, Cook J.T., Frank D.A., Berkowitz C., Black M.M., Casey P.H.., Cutts D.B., Meyers A.F., Zaldivar N., Skalicky A., Levenson S., Heeren T., and Nord M. Food insecurity is associated with adverse health outcomes among human infants and toddlers, Journal of Nutrition 2004; 134: RWJF (2008): Where we live matters for our health It is well-documented in medical literature that access to key resources – food, housing, fuel assistance – directly & significantly impacts health outcomes. Approximately 40% of diagnosed asthma among children is believed to be attributable to residential exposures. 3

5 Theory of the Problem Purpose of health care system: Identify & consider all significant conditions known to affect patients health and, where solutions exist, refer patient to solutions. Yet U.S. health care system does not provide screening and referral for social determinants of health

6 Theory of the Problem Why doesnt the health care system currently address patients unmet resource needs? 1.Lack of effective, affordable clinic-based infrastructure in hospitals/clinics to connect patients to these resources (e.g., Bellevue Hospital has two social workers for 60,000 pediatric patients clinic visits) 2.Insufficient leadership in health care sector (& beyond) to make this infrastructure pervasive

7 Project HEALTHs Vision 100% of clinics serving a substantial low- income patient population... Screen 100% of patients for key unmet resource needs... And refer 100% of patients with such needs to the required resources Project HEALTH envisions a health care system in which patients unmet resource needs are routinely and systematically addressed as a standard part of patient care.

8 Project HEALTHs Family Help Desk Model Demonstrates clinics capacity to address low-income patients resource needs in an affordable, effective manner Creates a pipeline of leaders with the conviction, knowledge, experience, and efficacy to create fundamental changes in the health care system to improve health outcomes for all Americans, especially those who are low- income

9 Project HEALTH Family Help Desk Health Care providers prescribe Family Help Desk to patients Patients walk by Family Help Desk & seek assistance Intake with clients with clients Follow-up with clients Close loop with providers about patients needs, resources provided Connect to community resources

10 Cities (NYC, Boston, Providence, Baltimore, D.C, Chicago) 6NYC Family Help Desks in Hospitals/Clinics Pediatric & Adult Primary Care Pediatric Emergency Dept Newborn Nursery Ob/Gyn Clinic Community Health Center Adolescent Clinics 183 Volunteers56373 Total Volunteer Hours (per year)100,000 (48 FTEs) 8,400 Families Served (per year)4, Children & Adults Impacted (per year) 12,1531,221 Impact: Current Scope of Services

11 Impact: On Families & Volunteers 50% of families with whom Project HEALTH NY maintains contact obtain at least one resource they need – i.e., receive food, secure child care, find a job or apartment – within 90 days of receiving services at the Family Help Desk. Volunteers continue to follow-up with all clients until they receive the resources they need or they can no longer be contacted (14% client disconnection rate) 83% of graduating Project HEALTH NY volunteers engage in graduate study or work related to health or poverty following graduation 100% of those volunteers rank the relative importance of their Project HEALTH experience in the selection of their post-graduate plans as high or very high (as compared to 7 other factors potentially impacting their plans)

12 Contact Information Chinwe Onyekere Executive Director- Project HEALTH New York Phone: Website:

13 Appendix B: Institutional Partners Hospitals/Health Centers Harlem Hospital Center Bellevue Hospital Center University of Chicago Comer Childrens Hospital La Rabida Childrens Hospital Friend Family Health Center Boston Medical Center Childrens Hospital Boston Uphams Corner Health Center (Boston) Hasbro Childrens Hospital/Rhode Island Hospital Johns Hopkins Medical Center Johns Hopkins Bayview Medical Center St. Agnes/Baltimore Medical Systems Baltimore Health Department/Total Health Care, Inc. Childrens National Medical Center Good Hope Road Health Center (Washington, DC) Universities University of Chicago Boston University Harvard University Brown University Columbia University New York University Johns Hopkins University of Maryland Baltimore County Loyola College George Washington University

14 Appendix C: Representative Project HEALTH Alumni Tara Abrahams, MBA, Director, Maverick Capital Foundation Atiya Ali, MPH, Senior Manager, Corporate Responsibility, Pfizer Inc. Afia Asamoah, JD, Special Assistant to the Principal Deputy Commissioner, Federal Drug Administration Kathleen Conroy, MD, MPH, Fellow, Department of Pediatrics, Boston Medical Center Kelly Doran, MD, NYU/Bellevue Emergency Medicine Residency Emilou Maclean, JD, Director, Medicins Sans Fronteirs Brian Milder, MBA, Director of Strategy & Innovation, Root Capital Craig Peskin, Investment Team, Highfields Capital Miriam Stone, Vice President of Business Development, VisionSpring Jessica Sultzer, MPA, Manager, Cause Marketing & Corporate Social Responsibility, Natl Football League Arianne Tjio, Sponsorship Committee Coordinator, Clinton Global Initiative Asia