Be Visible: Funders Support What They Know
ANWM once received an unsolicited $30,000 grant from a social investors' group in Grand Rapids because the program was well publicized and its leaders made time to speak publicly about their results. When the investors' group was looking to support a significant social issue through an organization that provided direct service and demonstrated results, ANWM quickly rose to the top of the list.
Use Data to Demonstrate Your Program's Value
ANWM has recruited corporate sponsors by visiting large corporations in the community and using data to describe the personal burden of asthma. For example, Karen Meyerson describes the number of area children with severe asthma and explains that when those children have acute attacks, they often use the ED for care and their parents are likely to miss work. This tactic has been successful for ANWM. Many corporations, including GlaxoSmithKline, Genetech/Novartis, AstraZeneca, Steelcase and Alticor, have supported the network. Similarly, when the Medical Directors of four local plans saw the cost savings data ANWM had achieved for Priority Health's members in ANWM's program, they also agreed to reimburse for home visits for their plan members in the area. ANWM model has proved so successful that some health plan partners have offered to reimburse asthma programs in other communities in Michigan, if they replicate ANWM in-home case management model. Two other communities in Michigan now are obtaining reimbursement for their case management services, which is patterned after the ANWM model. A comprehensive research project is underway to compare outcomes in the three communities now providing these services.
Make it Easy to Support Your Program
ANWM calculated the annual cost per patient for home-based intensive case management and invited funders and donors to sponsor one child for one year: $2,500 can reduce hospitalizations, ED visits and missed school and work days. By making it simple and making it hard to say no, ANWM successfully lined up a diverse and sustainable funding stream. ANWM was originally housed inside a hospital in Grand Rapids. The hospital was a founding member and, early on, ANWM found support within the hospital's infrastructure, such as the accounting department accepting checks and managing the bills. But as ANWM grew, its leaders found it hard to make the mission and organization clear when contribution checks were made out to the hospital rather than to ANWM. ANWM's decision to form an independent 501(c)(3) has greatly contributed to its sustainability. Being a 501(c)(3) allows funders to provide tax-deductible contributions; makes it simpler to give restricted funds, which are often slated for non-profit organizations; provides tax breaks for ANWM; and empowers ANWM to keep their own books and have ready access to complete financial information at all times.
ANWM was formed in 1994 when community leaders came together to address the rise in morbidity and mortality associated with pediatric asthma. In 1996, ANWM received funding for a demonstration project that would deliver home-based asthma care to uninsured and underinsured children in Grand Rapids whose asthma was leading to a high number of emergency department (ED) visits, hospital admissions and missed school days. ANWM now provides comprehensive home-based case management to children and adults, including asthma education, coordination with health care providers, development of asthma action plans (AAPs), home environmental assessments and social worker support.
STRONG COMMUNITY TIES--ENGAGE YOUR COMMUNITY 'WHERE IT LIVES'
Karen Meyerson, ANWM's Manager, credits her regular community presentations for calling attention to the program. When she staffed a booth at a community fair, for example, she met a foundation program officer who asked about ANWM. Karen has been asked more than once by program officers she met at similar events to submit funding requests based on the good work and impressive outcomes of ANWM.
Ensure Mission-Program Alignment
A committed group of health professionals joined forces to tackle the burden of asthma in West Michigan. These individuals shared a passion for children with asthma and held key positions of leadership in the community, which enabled them to parlay that passion into action. A key to their early success was a physician champion, Dr. Gary Kirk, who opened doors at local health care institutions and foundations and leveraged funding from key stakeholders to develop ANWM's direct service model.
Everything ANWM does is the result of a partnership and the network knows how to maximize the contributions of its members. By defining specific tasks and assigning responsibilities to one of the standing committees, ANWM has steadily achieved its goals. "Each committee is an integral part of the whole; attacking the asthma issue from differing perspectives," says Karen Meyerson, ANWM's Manager.
ANWM's care delivery model also relies on collaboration across the care team. For example, taking baseline severity assessments involves the home visitor such as a nurse or respiratory therapist (also a certified asthma educator--AE-C), a medical social worker, and families; the development of individualized AAPs to engage families, home visit team and providers; coordinated care conferences for providers, families and home visitors; and asthma education for school personnel and families.
ANWM also collaborates with a variety of groups to augment case management services, building on what already exists within the community. For example, when they recognized the need for a summer camp for children with asthma, instead of designing the program from scratch, ANWM partnered with the local children's hospital and area doctors and nurses to manage the camp. Similarly, when the local children's hospital created a Kent County Children's Medical Home Project to seek medical homes for children with Medicaid, they contracted with ANWM to provide asthma case management for children with asthma in the population.
Collaborate to Build a System that Will Last
The ANWM team knew that to create an organization that was effective and enduring, they had to convene and engage community health care leaders in a shared mission. "To get folks to collaborate, remind them that they're here because they care about asthma and have the ability to make a difference. They are not here to represent competing institutions," says Karen Meyerson.
HIGH-PERFORMING COLLABORATIONS--BUILD ON WHAT WORKS
To help partners recognize their opportunities for collaboration and ensure that a partnership approach was integrated into ANWM's organizational framework, the network's leaders called on early partners to "leave their affiliations at the door and to focus on the real challenge at hand: uncontrolled pediatric asthma in our community."
Use Evaluation Data to Demonstrate the Business Case
"We just wanted to prove that our model was compelling and effective, so we captured data and assigned costs to our outcomes from the beginning," Karen Meyerson said. ANWM partnered with Grand Valley State University faculty to track outcomes for 34 children over one year and demonstrated a total cost savings of $55,000 by pulling patient charts, asking hospitals for cost information, assigning dollar values to outcomes and comparing costs for the year preceding the program with costs in the first year. Upon seeing the results, Priority Health, ANWM's first health plan partner, agreed to reimburse ANWM for their home visit program in 1999, which is believed to be the nation's first agreement between a grassroots asthma coalition and a managed care plan. Contracts now exist between ANWM and five local health plans, with negotiations underway with two more health plans. ANWM receives reimbursement for home-based case management of individuals with Medicaid, Commercial or Medicare coverage. Third-party reimbursement now supports more than one-third ($190,000) of ANWM's total annual budget ($500,000).