The John A.Hartford Foundation 2001 Annual Report THE JOHN A T F O A R R D . HARTFORD FOUNDATION 200 H F . O A U N N 1 H D ANNUAL REPORT O A J T I E O H N T . 1 9 2 9 John A. and George L. Hartford, founding fathers of the John A. Hartford Foundation “It is necessary to carve from the whole vast spectrum of human needs one small band that the heart and mind together tell you is the area in which you can make your best contribution.” This has been the guiding philosophy of the Hartford Foundation since its establishment in 1929. With funds from the bequests of its founders, John A. Hartford and his brother George L. Hartford, both former chief executives of the Great Atlantic and Pacific Tea Company, the Hartford Foundation seeks to make its best contribution by supporting efforts to improve health care for older Americans. Statement of Purpose Founded in 1929, the John A. Hartford Foundation is a committed champion of health care training, research and service system innovations that will ensure the well-being and vitality of older adults. Its overall goal is to increase the nation’s capacity to provide effective, affordable care to its rapidly increasing older population. Today, the Foundation is America’s leading philanthropy with a sustained interest in aging and health. R T F O R Through its grantmaking, the John AA. D Hartford Foundation seeksH specifically to: Enhance and expand the training of F doctors, nurses, social. workers and other health professionals who care for elders, and O Promote innovationsA in the integration and delivery of services for all older people. U Recognizing that its commitment alone is not sufficientN to realize the improvements N it seeks, the John A. Hartford Foundation invites and encourages innovative H partnerships with other funders, as well D as public, non-profit and private groups dedicated to improving the health of O A older adults. J T I E O H N T . 1 9 2 9 Contents 2 Statement of Purpose 4 Report of the Chairman 6 Trustees 8 Staff 9 Strengthening Geriatric Nursing 10 The Nursing Shortage: A National Challenge 14 John A. Hartford Foundation Nursing Initiatives: 14 The John A. Hartford Foundation Institute for Geriatric Nursing 18 Building Academic Geriatric Nursing Capacity Initiative R T F O R 19 Five Centers of Geriatric Nursing Excellence: A D 20 Oregon Health & Science University School of Nursing H 24 University of Pennsylvania School of Nursing F 28 University of Arkansas for Medical Sciences College of Nursing . 32 University of California, San Francisco, School of Nursing O 36 University of Iowa College of Nursing A 40 Program Coordination U American Academy of Nursing 42 Geriatric Nurse Scholars Program American Academy of Nursing N N 46 Nursing School Geriatric Investment Program American Academy of Nursing 47 Enhancing Geriatric Nursing Education at the Baccalaureate H D and Advanced Practice Levels American Association of Colleges of Nursing 48 Creating Careers in Geriatric Advanced Practice Nursing O A American Association of Colleges of Nursing 49 Program Evaluation J The Measurement Group T 49 Conclusion I 50 2001 Grant Descriptions E O 58 Financial Reports 59 Financial Summary H N 60 Independent Auditors’ Report T 69 Summary of Active Grants in 2001 81 Application Procedures . 1 9 2 9 James D. Farley, Chairman of the Board Report of the Chairman For twenty years, the John A. Hartford Foundation has continued its commitment to helping our health system provide quality care for an increasing number of older adults. In 2001, we made substantial investments in this regard. Our program grants assisted skilled health professionals by fostering innovation and excellence in the delivery of services to senior citizens. This Annual Report highlights our efforts to address the problem of a shortage of nurses skilled in geriatrics. The Foundation has committed $34 million to a series of strategies which will help to reverse this trend. We continue our support for the John A. Hartford Foundation Institute for Geriatric Nursing at New York University. We have assisted nursing schools in the development of geriatric programs. We fund scholarships for nursing students at the under- graduate and graduate levels. We have also established a coordinating center at the American Academy of Nursing, and we are constantly evaluating these programs to see which ones fit our defined goal of progress in geriatric caregiving. In 2001, the Board of Trustees also approved several investments in the curricula used in the training of doctors, nurses and social workers. We provided funds to the American Association of Medical Colleges for the continuation and enrichment of geriatric content in the appropriate curricula. We made a grant to the American Association of Colleges of Nursing which enables 30 nursing schools to increase the geriatric content of their training. Our grant to the Council on Social Work Education has funded faculty members in 67 Bachelor’s and Master’s level social work programs. These efforts will expand the number, quality and performance of “aging-rich” courses and field work. During 2001, the Board also launched the Geriatric Interdisciplinary Teams in Practice initiative. This commitment builds on the Foundation’s belief that TEAM care can improve the health of older people. We will document the cost- effectiveness of these teams in five practice settings across the country. If successful, we hope that the results will speed the adoption of such collaborative approaches. 4 After six consecutive years of growth in our endowment, the Foundation’s assets declined to $588 million in 2001. Despite a drop in the endowment, we kept our grant payments virtually unchanged from the prior year: $24.9 million was our grant total. We are optimistic that our diversified investment approach will again produce growth in our endowment and allow us to sustain our grant programs. Finally, I would like to thank my colleagues on the Board of Trustees as well as the Foundation staff for their outstanding support. This team has made our work possible AND enjoyable. I salute them for the accomplishments described in this report. We look forward to continuing our important mission on behalf of older adults. James D. Farley Five Year Growth $650 $30 $600 $550 $25 $500 $450 $20 $400 $350 ASSETS ($ IN MILLIONS) $15 $300 GRANT PAYMENTS ($ IN MILLIONS) $250 $200 $10 '97 '98 '99 '00 '01 YEAR 5 Trustees James D. Farley CHAIRMAN Norman H. Volk PRESIDENT Kathryn D. Wriston SECRE TARY Anson McC. Beard, Jr. William T. Comfort, Jr. James G. Kenan III William B. Matteson Christopher T. H. Pell Thomas A. Reynolds, Jr. 6 7 Trustees James D. Farley CHAIRMAN Norman H. Volk PRESIDENT Kathryn D. Wriston SECRE TARY Anson McC. Beard, Jr. William T. Comfort, Jr. James G. Kenan III William B. Matteson Christopher T. H. Pell Thomas A. Reynolds, Jr. 6 7 Strengthening Geriatric Nursing Staff JAHF Nursing Initiatives Corinne H. Rieder EXECUTIVE DIRECTOR AND TREASURER Samuel R. Gische FINANCE DIRECTOR AND CONTROLLER Steve Abramovich, Jr. TECHNOLOGY OFFICER Sarajane Brittis PROGRAM OFFICER Marcia E. Brown EXECUTIVE ASSISTANT Eva Y. Cheng ACCOUNTANT Manuela Cruz-Galan RECEPTIONIST Christopher A. Langston PROGRAM OFFICER Julianne N. McLean PROGRAM SECRETARY James F. O’Sullivan GRANTS MANAGER Donna I. Regenstreif SENIOR PROGRAM OFFICER Laura A. Robbins SENIOR PROGRAM OFFICER Gary Romero PROGRAM ASSISTANT, GRANTS MANAGEMENT Joanne G. Trezos PROGRAM ASSISTANT - Paul V. Verrette PROGRAM ASSOCIATE AND EVALUATION MANAGER Maria A. Wilhelm ADMINISTRATIVE OFFICER 8 Strengthening Geriatric Nursing Staff JAHF Nursing Initiatives Corinne H. Rieder EXECUTIVE DIRECTOR AND TREASURER Samuel R. Gische FINANCE DIRECTOR AND CONTROLLER Steve Abramovich, Jr. TECHNOLOGY OFFICER Sarajane Brittis PROGRAM OFFICER Marcia E. Brown EXECUTIVE ASSISTANT Eva Y. Cheng ACCOUNTANT Manuela Cruz-Galan RECEPTIONIST Christopher A. Langston PROGRAM OFFICER Julianne N. McLean PROGRAM SECRETARY James F. O’Sullivan GRANTS MANAGER Donna I. Regenstreif SENIOR PROGRAM OFFICER Laura A. Robbins SENIOR PROGRAM OFFICER Gary Romero PROGRAM ASSISTANT, GRANTS MANAGEMENT Joanne G. Trezos PROGRAM ASSISTANT - Paul V. Verrette PROGRAM ASSOCIATE AND EVALUATION MANAGER Maria A. Wilhelm ADMINISTRATIVE OFFICER 8 The John A. Hartford Foundation The Nursing Shortage A National Challenge Jim Benson, 67, a widower with diabetes, was ordered to the hospital by his doctor with an alarming series of symptoms – extreme fluid buildup and shortness of breath. Dropped off by his daughter, she promised to return that evening after work. When she did, she was dismayed to discover that her father’s half-eaten dinner tray was laden with salty food. An aide apologized, explaining that the floor had been swamped with an unusual number of admissions that day. Understaffed and overworked, she would do her best to stay on top of the situation. The next morning, after a medication mix-up, Benson’s daughter decided that she would have to take a few days off from work and remain by her father’s bedside. A few days later, she was relieved to bring him home. But Benson, diagnosed with congestive heart failure, kept being readmitted to the hospital over the next year. In and out of the hospital fairly quickly, he was given a long list of instructions — about diet, medications, exercise — which he didn’t always remember or completely understand. He thought he was following orders but, within weeks, the same symptoms would reappear. Luckily, after his last readmission, as part of an experimental program to help patients recover better, which also cuts hospital costs, Benson was assigned a Nurse Practitioner with training in geriatrics to assess his needs before discharge, then provide support, guidance and oversee his recovery at home. She helped him set up a system for taking his medications, steered him away from processed foods which contain too much salt and arranged for a neighbor to stop by daily to see if he needed help with errands.