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Foundation promotes access to health care

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By Todd Cohen

RALEIGH, N.C. — Operating below the radar since it was formed in 1982, a small foundation in Raleigh has functioned as an incubator, think-tank and convener that generates ideas and plans, and the partners and funding to develop them, to improve health care for uninsured North Carolinians.

While continuing to focus on innovative programs to improve access to health care and coverage for the uninsured and poor, particularly in rural areas, the North Carolina Foundation for Advanced Health Programs also plans to expand its focus by working to improve the quality and effectiveness of care to the underserved, says Allen Feezor, its new CEO and president.

Headed for over two decades by Jim Bernstein, who died in June 2005 after serving as founding director of the state Office of Research, Demonstrations and Rural Health Development, the foundation has received over 45 grants totaling $25 million to help address emerging health-care issues.

In addition to spending $3 million to $6 million a year in grant funds it receives to support its specific projects, the foundation raises money through an annual mail appeal and annual dinner to support a program of scholarships and fellowships named for Bernstein that it administers.

Last year’s dinner attracted 210 people and netted roughly $25,000, with this year’s dinner scheduled for Oct. 18 at the Friday Center in Chapel Hill.

The foundation pursues projects in response to ideas generated by state government, by foundations and by its own staff and partners, says Feezor, former chief planning officer for University Health Systems of Eastern Carolina.

Key projects the foundation currently is spearheading include:

* Development of a system to manage care for Medicaid patients in 99 of North Carolina’s 100 counties, or 10 percent of the state’s population.

* An initiative to integrate mental health and primary care.

* An effort to create a special licensing designation to raise standards for the workforce providing long-term care.

* Development of a program to provide health-insurance coverage for all uninsured children in the state.

To develop those projects, the foundation typically works to enlist funders and partners in North Carolina and nationally.

The effort to develop a care-management system for Medicaid patients, for example, received funding from the Kate B. Reynolds Charitable Trust in Winston-Salem, the Center for Health Care Strategies in Washington, D.C., and the Commonwealth Fund in New York City, and from pharmaceutical companies GlaxoSmithKline, AstraZeneca, Novartis, Merck and BristolMyers Squibb.

Designed and developed in collaboration with the state Department of Health and Human Services, the project was launched in 1998 and has resulted in the creation 15 independent community-based networks that serve over 700,000 North Carolinians enrolled in the federal Medicaid program.

“They have really been the catalyst for a lot of innovative programs throughout the years,” says John Frank, director of the health care division at the Kate B. Reynolds Charitable Trust.

Many of those startup programs, some of which the Trust has helped fund, later are expanded with support from other organizations, including state government, Frank says.

“The foundation has operated largely out of the spotlight and provides a unique link between the public programs and the private sector’s delivery of health care, and will continue that,” says Feezor, who also served as executive administrator of the California Public Employee Retirement System, the third-largest purchaser of health care in the United States, and as North Carolina’s chief deputy insurance commissioner.

“Our vision,” he says, “is to work towards a North Carolina in which the availability and access to quality care for North Carolina’s residents is not limited by payer source, income, geography, age, ethnicity or health status.”

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