Families U.S.A. (United for Senior Action) Foundation.

Abstract

GrantWatch Health AffairsVol. 8, No. 3 Profile, Grants, and OutcomesLinda G. Greenberg AffiliationsShe compiles the GrantWatch section for each issue.PUBLISHED:Fall 1989Free Accesshttps://doi.org/10.1377/hlthaff.8.3.221AboutSectionsView PDFPermissions ShareShare onFacebookTwitterLinked InRedditEmail ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsDownload Exhibits TOPICSElderly careGrantsEducationLong-term services and supportsAccess to careHIV/AIDSLow incomeHealth servicesMedical educationDisabledFamilies U.S.A. (United for Senior Action) FoundationIn August 1989, The Villers Foundation changed its name to the Families U.S.A. (United for Senior Action) Foundation, to reflect the foundation's focus on the central-ity of families in the lives of older Americans. The foundation, established in 1982 by Philippe and Katherine Villers with a commitment of $40 million intended to span twenty years, is dedicated to self-empowerment, intergenerational, and advocacy projects that involve poor and low-income elderly and their families. The name change was spurred by plans to broaden the foundation's financial base and to increase involvement of people who share the foundation's priorities for improvements in health care, long-term care, income security, housing, and the role of elderly in society. The foundation's new name signals a commitment to pursue these goals indefinitely.“The foundation's purpose is to contribute to the development of social policies that will vastly improve the quality of life for people as they age in our society, with particular focus on the economically vulnerable,” Kate Villers, executive director of the foundation's Massachusetts office, said in an interview. The foundation's mission “to nurture a movement of empowerment among elders” encourages elders to become community leaders to expand the rights of all Americans to health care, housing, and income security.The foundation's main office is located in Washington, D.C., with a sister operation in Boston that funds programs limited to Massachusetts. Ronald Pollack, executive director of the Washington office, said in an interview, “One of the chief directives of our Board of Directors is to empower people who are constituencies so that they can conduct their own advocacy work. The foundation will continue to fund studies and analysis that will contribute to public policy debates.”Advocacy EffortsThe Families U.S.A. Foundation is a rarity in the private foundation world in that its benefactors are unusually active. Since 1982, Kate Villers has served as the executive director of the Massachusetts office. Phil Villers is involved in several advocacy and human rights organizations. It is through the Villers's philosophy to effect change and improve public policy that they also have provided separate financial support to the Villers Advocacy Associates, established in 1984, for work on key legislative issues affecting low-income elders.In 1988, the Villers Advocacy Associates advocated legislation to protect assets and income for those elderly whose spouses are admitted to a nursing home, and legislation to protect seniors and disabled persons below the poverty line from cost sharing in the Medicare program, both as part of the Medicare Catastrophic Coverage Act of 1988. A main program of the Villers Advocacy Associates is the Advocates Senior Alert Process (ASAP), a collaborative project of seventeen national aging organizations, to motivate and inform activists on key legislative issues. “Action alerts” serve to educate ASAP members on key public policy issues and provide them with effective advocacy tips to communicate with Congress regarding specific legislation.The Villers Advocacy Associates has been replaced by Families U.S.A. (United for Senior Action), a tax-exempt 501(c)(4) organization, to continue its activities. The new organization will receive its support from a direct mail effort. The Families U.S.A. Foundation and Families U.S.A. remain independent of each other. Although at times some of the foundation's staff work for the advocacy organization, separate operations are maintained, including payroll, postage, telephone, and other expenses.Program Funding AreasHealth costs and access.The foundation's activities reflect a deep concern for escalating health care costs and access problems. Funding to Americans for Health in Washington, D.C., commonly known as the National Health Care Campaign, has supported efforts to research and help state and local organizations increase access of low-income uninsured or underinsured persons to health care, and to improve the health care system. In Massachusetts, the foundation has funded the Health Care for All (HCFA) project since its formation in 1984 by the Massachusetts Human Services Coalition, a coalition of consumer advocacy groups that works with community groups, legal advocates, and policy analysts on health and human services policy change. HCFA is currently representing consumer interests in implementing the state's universal health care access legislation, and is developing solutions to long-term care problems for the state's elderly and younger disabled population.Long-term care. The foundation takes an active approach to addressing problems in long-term care through research and public education efforts. The foundation has supported two publications that discuss a social insurance approach to financing long-term care. In September 1989, the foundation released Because Were All In This Together: The Case for A National Long Term Care Insurance Policy , by Robert Ball with Thomas Bethell. The foundation provided partial support to The Brookings Institution for a widely discussed book released in 1988 by Alice Rivlin and Joshua Wiener, Caring for the Disabled Elderly: Who Will Pay?The foundation supports efforts that draw attention to the important federal role in solving long-term care problems. “The area of long-term care is totally neglected in our society. There needs to be a lot of work in this area, more networking, coalition building, and policy exploration from the point of view of the consumer,” Kate Villers said. This preference for public-sector intervention to solve long-term care problems varies greatly from some other private foundations that favor private-sector and market-driven approaches to long-term care.The Families U.S.A. Foundation and the American Association of Retired Persons (AARP) jointly supported a sucessful public education program to put long-term care into the realm of open public debate during the 1988 presidential and congressional elections. The “Long Term Care '88” initiative, led by a national coalition of religious, social service, and senior organizations, brought the issue to the New Hampshire and Iowa presidential primaries. The foundation also supported a national poll of Americans' views on long-term care that showed concern about caring for disabled family members, support for increased government action, and a willingness to pay additional taxes to finance wider availability of long-term care services.Other foundation grants in this area have focused on research. The Intergovernmental Health Policy Project at George Washington University received funding to produce a report on current state programs and policies affecting the delivery of long-term care. The United Seniors Health Cooperative in Washington, D.C. received funding to examine private long-term care insurance policies' provisions for home care services and nursing home coverage.Income security. The foundation has made income security a priority funding area to alleviate poverty among older Americans and to ensure that federal “safety-net” programs established for low-income elderly meet their needs. Low-income elders have benefited from incremental improvements in Social Security. However, as outlined in the foundation's 1987 publication, On The Other Side of Easy Street , the poverty rate among the elderly remains the highest among all adult age groups. Minorities and women, in particular, suffer at disproportionate rates. Testifying by invitation before a House of Representatives committee in March 1989, Pollack reported that the federal Supplemental Security Income (SSI) program has had numerous shortcomings, including benefit levels that fall well below the poverty line. According to a foundation-supported survey of more than 6,000 elderly persons, lack of information and understanding about SSI, its eligibility requirements, and complexity of the application process are obstacles to elders' participation in the program. The report, SSÍ AWARE: Why the Elderly Poor Don't Get the Help They Were Promised , released in April 1989, indicates that current outreach and public information about the SSI program is limited and untargeted. Similiar findings from surveys and outreach projects were released earlier this year by AARP, with support from The Commonwealth Fund. The Massachusetts office of the Families U.S.A. Foundation is providing public education and outreach with the goals of enrolling elderly and disabled persons in the SSI program, testing various outreach and advocacy methods, and informing policy advocates about access barriers. Project SIGNUP has recruited and trained VISTA volunteers for outreach and screening efforts in targeted low-income and minority neighborhoods to educate and assist persons potentially eligible for SSI. Additional support for the project has been contributed by the Boston Foundation, the Bank of New England, and the City of Boston.Empowerment.The elderly are not a homogeneous group. Through its support for organizing and self-empowerment projects, the foundation has sought to change ageist stereotypes of elders as either wealthy “surplus people” who have little to contribute to society or as feeble and burdensome obligations to families and the public. Instead, it assists groups of elders to collectively advocate on their own behalf and encourages multigenerational organizations to include elders in their activities. The foundation views housing, health care, and a minimum income as social entitlements. It is committed to these funding areas and does not want them to continue as charity. The foundation, in addition to its funding in health care and income security, supports education programs to increase elderly tenants' and low-income homeowners' awareness of their housing options and rights.Funding StrategyThe Families U.S.A. Foundation plans to continue to prioritize its funding to address the needs of low-income elders and their families. The foundation also will continue to fund projects and analyses that connect with public policy issues. One area for possible expansion is in increasing opportunities for volunteerism and employment among elderly people to further strengthen their capacity to contribute to society.To increase its grant-making power, the Families U.S.A. Foundation collaborates with other foundations whenever possible. However, the foundation acknowledges difficulty in getting multifoundation funding for activist-oriented projects. “Advocacy and social activism for many foundations are buzzwords that are pejorative, but with Phil and Kate Villers, and the Board of Directors, it is quite the contrary,” said Pollack. The foundation's funding strategy includes a strong commitment to provide training and technical assistance to grantees and groups being considered for funding. This includes help with developing programs, training leaders, recruiting members, and teaching grass-roots fund raising and bookkeeping. The foundation awards grants on a matching basis and helps grantees seek other sources of financial support to become economically self-sufficient. It publishes a manual, entitled The Best Medicine: Organizing Local Health Care Campaigns , to help community groups organize and effect change in their local health care systems. The manual's first supplement, The ABCs of DRGs: How to Protect and Expand Medicare Patients' Rights , released in February 1988, provides more information on local health care advocacy campaigns. The foundation's three-year report for 1986–1988, released in August 1989, reported that the Washington office awarded grants to seventy-six local projects and forty-one advocacy and special projects totaling $1.92 million in 1988. The Massachusetts office awarded twenty-nine grants totaling $221,235 in 1988.III. GrantsIndependent foundations' primary focus is grant making. In general, their assets come from the gift of an individual or family. Community foundations' assets usually come from many donors rather than a single source, and grant making is limited to a particular region. Community foundations are usually classified as private charities under the tax law and are subject to different rules and regulations than are other private foundations.Access To CareAccording to 1988 Census Bureau estimates, over thirty-one million Americans are without health insurance. The demographics of these people are diverse, and their ranks continue to grow as the service industry burgeons and as competition in health care increases. Regional disparities in access also exist. Foundation funding in this area ranges from economic analyses of the problem to direct provision of care.Independent Foundation Grants:Community Home Health Services of Philadelphia, Philadelphia, PA.This grant will support the Indigent Care Program to provide comprehensive home health services, including nursing, physical, occupational, and speech therapies; social work; and other health services for all Philadelphians, irrespective of ability to pay.$220,000 over two years. Funded by The Pew Charitable Trusts.Denver Health Care For the Homeless Program, Colorado Coalition for the Homeless, Denver, CO.Funding will support the Stout Street Clinic, a medical clinic for homeless adults and children in metropolitan Denver. The clinic's services include prenatal care, psychiatric evaluation and treatment, dental care, social services, employment referral, housing assistance, mental health counseling, and substance abuse services. This grant will allow the clinic to meet a matching fund requirement from the U.S. Public Health Service. In 1985, the clinic received a $1.4 million grant from The Robert Wood Johnson Foundation.$300,000 over three years. Funded by The Colorado Trust.The Greater Tampa Urban League, Tampa, FL.Life expectancy is lower for black males than for whites or other minority groups. Funding will support a program to improve the health of disadvantaged young black males, ages ten to eighteen, in a predominantly black community in the Tampa area. The program aims to increase the use of primary health care and social services and to provide health education relevant to African-American culture.$988,570 over three years. Funded by the W.K. Kellogg Foundation.Total Action Against Poverty in Roanoke Valley, Salem, VA.Funding will support the Comprehensive Health Investment Program (CHIP) to improve access to health care for children of low-income families. Physicians will provide preventive, acute care, and case management services. Coordinated community services, including outreach, will serve to strengthen and encourage the self-sufficiency of the families.$1.5 million over four years. Funded by the W.K. Kellogg Foundation.AIDSAlthough foundations traditionally have avoided disease-specific giving, the immediate threat posed by acquired immunodeficiency syndrome (AIDS) has caused many foundations to redefine their grant-making policies. A 1988 report found that the level of giving for AIDS research and education has topped $51 million and continues to increase.Independent Foundation Grants:American Foundation for AIDS Research (AmFAR), New York, NY.Funding will support the Montefiore Medical Center in New York to study ethical issues that hamper clinical research efforts to develop AIDS treatments. In 1990, guidelines from this study will be published for conducting AIDS-related clinical research that may speed the development of AIDS treatments and increase the number and variety of human immunodeficiency virus (HIV-infected persons participating in clinical trials.$100,000 over one year. Funded by The Charles A. Dana Foundation.Friends Outside in Sacramento, Sacramento, CA.Funding will establish an AIDS education and prevention program for high-risk individuals in the Sacramento County jail system.$41,930 over one year. Funded by The Sierra Foundation.San Francisco AIDS Foundation, San Francisco, CA.The number of women diagnosed with AIDS and AIDS-related complex (ARC) continues to increase. Women comprise approximately 9 percent of all AIDS cases. This grant will support the Women's Services Program, an advocacy and case management model program to meet the needs of women with AIDS and ARC. The program helps women gain access to housing, food, clothing, child care, transportation, medical care, legal advice, and substance abuse treatment. Support groups are an integral part of the program.$84,000 over three years. Funded by the Public Welfare Foundation. $25,000 over one year. Funded by the Hearst Foundation.Health Care For The ElderlyBy the year 2000, 13 percent of the U.S. population will be over age sixty-five. Planning for the financing and humane provision of medical and social services for this group is becoming an urgent task for both the public and private sectors. Foundations are devoting resources to all aspects of the challenge.Independent Foundation Grants:California Public Health Foundation, Berkeley, CA.Funding will support a survey to reinterview elderly persons, ages seventy to ninety-four, who are participants in the Alameda County Project. This ongoing study began in 1965 to learn how social factors and health behavior relate to changes in functional ability and vulnerability to health problems, among a representative sample of adults in California's Alameda County. Participants have been interviewed on demographic, behavioral, social, psychological, and health factors that may relate to health status. These survey analyses offer policy-relevant information about problems the elderly face.$194)937 over two years. Funded by The Henry J. Kaiser Family Foundation.Center ior Intergenerational Learning at the Institute on Aging, Temple University, Philadelphia, PA.Funding will support the Delaware Valley Intergenerational Network (DELVIN) to increase the number and quality of intergenerational activities for youths and elderly persons. DELVIN fosters cooperation between religious, health, human service, educational, and cultural organizations to develop intergenerational programs and share resources in a six-county area. Additional funding has been contributed by the Philadelphia Foundation and several corporations.$100,000 over two years. Funded by The Pew Charitable Trusts.Institute of Medicine, National Academy of Sciences, Washington, DC.This grant will fund an expert panel to conduct a twenty-two-month study of thirteen health risk factors, including hypertension, medications, infectious disease, osteoporosis, and visual and hearing sensory loss, among others, in persons over age fifty. The study will identify interventions to prevent disease and disability, gaps in knowledge, and research areas. A final report is expected in July 1990. The project has received support from the National Institute on Aging of the National Institutes of Health.$100,000 over one year. Funded by The Charles A. Dana Foundation.$100,000 over one year. Funded by The Pew Charitable Trusts.Reducing Functional Deterioration in the Hospitalized Elderly Patient Program,This initiative will address the deterioration of elderly patients' functional status during hospitalization. Funding from The John A. Hartford Foundation will help six medical centers to implement and test the effectiveness of interventions to enhance functional status. The foundation is currently reviewing how to gather the six medical centers' results to enable further analysis.$2.5 million over three years. Funded by The John A. Hartford Foundation . Selected grants: Cedars-Sinai Medical Center, Los Angeles, CA.$485,884 over three years to develop an in-hospital “conditioning” program to maximize physical fitness among a test group of acute care patients over age seventy.St. Mary's Hospital Medical Center, Madison, WL$460,418 over three years to support a clinical test of a multidisciplinary intervention program for elderly patients admitted to the hospital for problems associated with a high degree of functional dependency at the time of hospital discharge.Stanford University, Stanford, CA.$499,721 over three years to examine the loss of mobility among elderly patients involving a control group that will take part in physical therapy, and to examine the impact of a caregiver's attention and optimism on the patient's improvement.University Hospitals of Cleveland, Cleveland, OH.$484,998 over three years to examine causes of and potential prevention approaches to “hospital dysfunctional syndrome” among elderly patients.University of Chicago, Chicago, IL.$307,406 over twenty-eight months to identify and treat delirium among hospitalized elderly. The program will test whether a standardized assessment protocol, administered by geriatric and nursing consultants, can reduce illness associated with delirium.Yale-New Haven Hospital, New Haven, CT.$448,668 over thirty months to develop a model of inpatient care for frail elderly patients to prevent and treat confusion, immobility, and dependence on medications.United Seniors Health Cooperative (USHC), Washington, DC.The elderly spend an estimated $14 billion yearly on private “Medigap” health insurance to supplement their Medicare coverage. As much as $3 billion may be spent on duplicative coverage. This grant will support efforts to develop and disseminate a computer service, Medigap Insurance Counseling Software, that enables older persons to better understand and make informed choices regarding their Medigap or health maintenance organization (HMO) coverage. USHC plans to develop and incorporate recent Medicare changes, such as the Medicare Catastrophic Coverage Act of 1988, into the software to better serve the needs of low-income older persons, and to make the service available to organizations nationwide.$99,143 over one year. Funded by the Public Welfare Foundation.Community Foundation Grants:Jewish Family Service Association of Cleveland, Cleveland, OH.Funding will support an in-home respite care demonstration for Alzheimer's patients in the eastern suburbs of Cleveland. The program offers counseling and support groups for Alzheimer's patients and their families, social services for those with special needs, and ongoing respite care. It includes an outreach model for persons in the early stages of Alzheimer's disease. The program has received additional support from the United Way of Cleveland and the Jewish Community Federation of Cleveland. $73,620 over one year. Funded by The Cleveland Foundation.Health Care FinanceHealth care costs continue to escalate. The United States spent over $500 billion on health in 1987, or 11.1 percent of its gross national product. From 1986 to 1987, costs increased 9.8 percent. Health costs continue to rise much faster than the overall inflation rate (44 percent in 1987). Foundations have funded various experiments that use alternative delivery systems to provide cost-effective care.Independent Foundation Grants:State of Connecticut Office of Policy and Management, Hartford, CT.Funding will support a demonstration of a public/private model of long-term care insurance. This continuation grant is funded through the Program to Promote Long-Term Care for the Elderly, a $3.2 million Robert Wood Johnson Foundation national program begun in 1988. The first phase of the program was a feasibility study of public/private insurer cooperation, with Medicaid assuming long-term care expenses.$1,799,996 over three years. Funded by The Robert Wood Johnson Foundation.Health Professions EducationHow health personnel are trained is crucial to effective health care delivery. Foundations are focusing on medical school curricula, the nursing shortage, and minorities in health professions.Independent Foundation Grants:The American Federation for Aging Research, New York, NY.Funding will support research grants to encourage clinicians to conduct research in aging and will provide summer scholarships to medical students to work in geriatrics programs at major medical centers. Under this grant, six $25,000 awards will be provided to physicians to research geriatric syndromes.$204,000 over three years. Funded by The Charles A. Dana Foundation.University of Washington School of Medicine, Seattle, WA.This grant will support research and training in ecogenetics. This emerging field in the environmental health sciences examines how genetic characteristics make an individual more or less susceptible to birth defects, neurologic diseases, cancer, and other diseases known to be caused by exposure to toxic chemicals. Research requires a coordinated effort between medical and human genetics, and toxicology and epidemiology. The program's goal is to identify specific risks from exposure to certain toxic chemicals in the environment, to identify ways to avoid such contact, and to develop treatments for patients already ill from toxic exposures. This funding initiative will support similar efforts at other academic medical centers.$637,000 over three years. Funded by The Charles A. Dana Foundation.Health Promotion/Disease PreventionResearch continues to document the effect of diet, exercise, and lifestyle on health status. Preventable illness and injury claim over a million American lives each year. In 1986, over twelve million potential years of productive life were lost, costing the nation hundreds of billions of dollars. As these costs become apparent, foundations join the effort to promote healthy behavior.Independent Foundation Grants:Improving the Health of Native Americans Program.In the first phase of this three-year national initiative, thirteen Native American community health care programs in eight states will receive funding to improve health care among tribal populations. The program encourages tribes to develop solutions to their urgent health problems. Grants will support health promotion and disease prevention, alcohol and drug abuse prevention, health services for women and infants, an intergenerational health program, and programs to reduce domestic violence and control diabetes.$6 million over three years. Funded by The Robert Wood Johnson Foundation. Selected grants:Chilchinbeto Health and Development Corporation, Kayenta, AZ.$247,843 over two years to expand services and improve management of an independent, community-run ambulatory health clinic and program in two reservation communities for the Women's Health Initiative—a model of health services delivery to Navajo women.Coeur d'Alene Tribe of the Coeur d'Alene Reservation, Plummer, ID,$107,189 over one year to develop a home health care program that combines a traditional Native American approach to health care with modern medical practices.Sinte Gleska College, Rosebud Indian Reservation, Rosebud, SD.$225,999 over three years to prevent alcohol and drug abuse via counseling, educational activities, community-based development programs, and an information resource center in two reservation communities.University of Medicine and Dentistry of New Jersey, The Robert Wood Johnson Medical School, Piscataway, NJ.This grant will support a program to develop comprehensive educational materials for community-based alcohol and drug abuse education and prevention programs. Partnerships will be developed between the medical school, community-based organizations, and an expert panel of educators, researchers, and specialists in alcohol and drug abuse problems. The program will develop an internship for prevention specialists to study public health approaches to prevent alcohol and drug-related problems. The internship program will serve to bridge the gap between researchers in the academic community and practitioners in the field.$375,000 over two years. Funded by The Pew Charitable Trusts.International HealthThe health problems facing less-developed countries are overwhelming. High birth rates, poor maternal and child nutrition, vector- and water-borne diseases, and now AIDS have taken a large toll, especially on infants and children. Foundations have funded continuing medical education, tropical disease research and control, family planning, and nutrition.Independent Foundation Grants:Foundation of the University of Medicine and Dentistry of New Jersey, Newark, NJ.Funding will support a demonstration project of an electronic communication system within an international network of medical schools. These community-oriented schools are members of the Educational Institutions for Health Sciences and are located in Canada, Egypt, Indonesia, Nigeria, Thailand, and the United States. This joint project by the University of Medicine and Dentistry of New Jersey-NewJersey Medical School and the McMaster University Faculty of Health Sciences in Hamilton, Ontario may serve as a model in professional education and international health since many of the participating schools are in developing countries.$150,000 over eighteen months. Funded by The Pew Charitable Trusts.Ministry of Public Health and Social Wei-fare of Paraguay, Asuncion, Paraguay.Funding will support a community-based health care service model to improve health care for pr