The Foundation held its annual meeting on Thursday, March 10, 2011 on what turned out to be a rainy and sloppy night that kept the attendance down compared to recent meetings.  I was not able to attend the meeting because I had flown out to California two days earlier to be with my mother, who was dying of cancer.  She passed away a few days later.  It was a privilege to be able to be at my mom’s side, but I was sorry to miss my first annual meeting in the eight plus years I’ve served as executive director.

We will be posting material from the annual meeting on the web page in coming weeks.  I thought I would start with the remarks I had prepared for the meeting, summarizing OHF’s year.  Meg Seely read them at the meeting.

It has been a strong year for the foundation. I just want to mention five points that I think capture the work of the foundation in 2010 and then touch briefly on a thought for 2011.

1. Overall Grantmaking

The core of our work, in 2010, the foundation made nearly $189,000 in grants, up $37,000 from 2009, but not quite back to the 2006-08 years. Our grants split into our three traditional categories: organizational, good neighbor and educational. We have shifted what were our old educational grants into organizational, but we made our first payment in our Loan Forgiveness program, designed to help retain the two physician assistants at the health center, Laura Vahey and Judi Friedman, who joined the staff there in 2009 and 2010.

In organizational grants, in addition to continuing our outcome based grantmaking to 18 organizations, I want to focus on two projects in particular as points two and three: the Community Care Coordinator and the Oral Health Initiative.

2: Community Care Coordinator

The brainchild of Lynn Peterson, board member, physician and collaborator extraordinaire, the community care coordinator was developed to provide a single person to help navigate what can be a bewildering health care system, so that patients are able to follow their treatment plan, review their individual needs in their home-setting and access community resources. As I am in the midst of supporting my parents, as my mom was diagnosed with inoperable brain tumors earlier this year, I’ve seen up close the value of having a community care coordinator—if my brothers and I and our families weren’t available to help with the needed coordination.

This project has been in the works for several years and it has now come to fruition, with a grant from the Foundation to Mt. Ascutney Hospital, which was able to contribute some state Blueprint for health funding, the Health Center has hired Susan Jantos, who has been on the job since mid-January. Susan, could you stand. We are lucky to have someone with Susan’s experience and dedication in this position. To help her in her work, an advisory committee made up of the various partners who collaborated to make the project work has been assembled.

At last year’s annual meeting we heard from Lori Kenton, who runs a similar model in Lyme, New Hampshire. Perhaps next year, Susan will come to tell us what she’s learned one year in.

As the CCC as we call it, came together this year, a fortuitous event happened which has allowed us to take collaboration one step further. The Martha Lussier Health Information and Referral Service has been ably staffed for many years by Lynne Tracy, carrying on the work that Martha Lussier herself had done. When Lynne announced that she needed to leave her position to take on running a family business, without missing a beat, the HIRS board suggested exploring whether the Community Care Coordinator might take on the function that Lynne had been handling. After discussions with the Foundation and Mt. Ascutney Hospital, it was agreed the CCC would take on this work, that HIRS would contribute financially to the project and that if all goes well, HIRS will look at folding its organization in with the Foundation, hopefully later this year. This exiting development shows the strength of our community’s commitment to collaboration and getting the work done efficiently and effectively.

3: Oral Health Initiative

One of the access issues that we’ve seen in our Good Neighbor Grant program, and I’ve mentioned at previous annual meetings, is the high demand for help with dental issues. This past year, we really focused on this topic. Aided by a gifted intern from the Dartmouth Institute’s masters in public health program, Vanessa Hurley, we took a look at what the scale of the unmet oral health need was in our service area. As she dug deep into the statistics of need, we were able to verify what may be obvious intuitively to many of you—that for every person we are able to help with a dental Good Neighbor Grant, there are at least another 10 or 20 who have an untreated oral health need and lack the resources to be able to treat it.

We shared these research findings with an Upper Valley group of dentists, health care providers and funders that I have been a part of, who have been working on addressing oral health needs in the region for several years. Armed with this knowledge, and buoyed by a special grant that the foundation had received that could serve people outside of our service area, we were able to raise funds from three other local sources, including the United Way, to launch an Upper Valley oral health public awareness initiative, to try to raise awareness of the need. The project has created a web page and is in the process of collecting stories to show the need and promote good oral health. We have a new TDI intern who will be collecting stories this Spring.

4: Good Neighbor Grants

In a conversation last week with some board members we were talking about how we might focus our attention on what makes the foundation unique. One of the programs we’ve been doing for a while that is as unique as it is simple, is our Good Neighbor Grant program. It’s simple premise is that there our people in our community who cannot afford the health care that they need. When there is no other source that can help them, the foundation takes a look at what is requested, sees whether any treatment can wait or be scaled back without effecting care, sees what the applicant can contribute based on their income and what the provider can forgive, and then makes a payment on behalf of the person in need. We are rightly proud of this program, and the $315,000 we’ve given out in the past five years, and the nearly $72,000 this past year on behalf of many community members. Judith Smith from our office has done a fabulous job of talking with applicants, providers, insurers and others to make this program work so well these last five years.

5: Operations Changes

Finally, in 2010, we continued to try to make improvements in the way we operate:

• We revised our web page, www.ohfvt.org – take a look!

• We focused on prioritizing staff time to be as productive as possible: I reduced the time I spent on real estate and good neighbor grants and examined more closely the time I spend in general grant administration, while increasing my time spent on fundraising, marketing and community leadership activities—we didn’t quite reach our fundraising goals, but we came close and end of year pledges and donations that came in early in 2011 got us to where we wanted to be;

• We implemented a passive management approach to the endowment, saving finance committee time, fees and with fine results;

• With our real estate, we filled the Simmons House vacancy brought on by Vermont Children’s Aid closing up shop, we remodeled an office that became available on the river level of the Health Center when Mt. Ascutney gave up some space (It’s available—460 square feet, three offices, two with the best view in town for the right health care provider!) and we conducted an energy audit with help from Efficiency Vermont which we’ve begun to implement, improving lighting—next will tackle making the heating more efficient and buy a new chiller from our healthy capital reserve.

Looking Ahead: 2011 and Beyond

Looking ahead to 2011 and beyond, the foundation has an opportunity to play a key role in the future of health care. As a health foundation, we need to be cognizant that on both the state and federal level that the future of how health care will be delivered is very much in transition. There is a federal law on the books that won’t be fully implemented for several years. It is subject to lawsuits as to whether it will be implemented at all. If it lives up to its promises, it will result in another significant segment of the population having coverage and it will also result in a good deal of activity exploring ways to control health care costs. (Unfortunately, for oral health, it only applies to children, and it only seeks to bring the nation’s children up to where Vermont children already are.) As a result of federal stimulus dollars, local hospitals are implementing electronic records, that may, once the kinks get worked out, result in a sea change in record keeping.

At the state level, a new Governor campaigned on wanting to create a publically financed health care system and he has colleagues in both houses of the state legislature interested in pursuing this. He says we must do this in order to control costs. How we do this, we’ve only seen a short glimpse of in a report that came out at the beginning of the year.

What’s clear to me, and this was pointed out by a friend of the foundation in a lunch earlier this year, is that our current health care system is profoundly dysfunctional. It needs to transition from where it is now to a more functional system. There is a fairly large gap, as articles by Dr. Atul Gawande in New Yorker and others clearly show. So to get from where we are now, from where we need to be, I wonder if there isn’t a role for our foundation, to try things out an a micro level, in our community of 10,000, to help lead towards that place we need to go? The community care coordinator is an example of that movement, and I think we are looking at ways to do that for oral health on a regional level. I wonder as the board approaches a retreat this spring if it wouldn’t be time well spent to consider what resources of the foundation might be brought to bear to assist in a transition to where we need to get the health care system to be. As the nation and the state are focusing on this issue, I believe we are ideally situated to help be a leader in this area.  Thank you.