by Nick Randell, Program Officer
I had the opportunity to attend the Grant Makers in Health
Conference in Austin a few weeks ago. This is a conference that Tower staff have not attended before. In the last few years, the conference has
widened its focus on behavioral health issues, so we decided it was time to
give it a try. I have to admit that I am
just not ready (and maybe never will be) to "live tweet" anything. So instead of real-time tweet-worthy
impressions from the Live Music Capital of the World, you get this. And you have to read to the end for the music
The first day of the conference, I attended a networking
breakfast for Behavioral Health funders. This is a big event (the conference had over 600 attendees) - and there
were probably 200 plus people at this early morning session. But it was soon
clear that connections would not be too hard to make. The conference attendee on my left was from
my mother's home town in northwest rural Pennsylvania, the attendee on my right
from a foundation that is a co-funder on one of our children's mental health grants
in Massachusetts. Former U.S. Representative Patrick Kennedy spoke briefly at
this session, beating the drum for evidence-based practices in mental health
and support for implementation fidelity and greater focus on results.
The conference kicked off in earnest with a plenary speaker,
Diane Meier, the director of The Center To Advance Palliative Care. She had a degree from Oberlin College (my
alma mater), so I settled in for what was sure to be a most excellent talk,
though I wasn't sure palliative care would resonate with Tower's work. Turns out that I had some misconceptions
about palliative care (it's not just for the elderly or terminally ill), and
the argument in favor of patient-centered case management does apply to our
grantmaking. I cleaned up my notes a bit, and I offer them here:
- System design actually drives
patients to "misuse" emergency departments. Rx offices with recordings that
tell patients to call 911, for example.
- This talk is basically an argument
for wider support of person-centered, family-focused palliative care.
- Higher quality (like
supportive case management) will lead to lower costs
- Misconception that palliative
care is about end of life care, more about serious illness, chronic pain, and
related problems. Frailty and dementia are big issues. Focus on supporting caregiver
is key. Palliative care appropriate for any age, any diagnosis.
- Exhausted, unsupported
caregivers are what lead to repeat emergency room visits.
- Studies have shown that
palliative care prolongs life. It is
not synonymous with hospice. Reduction in depression may be key benefit.
- Unpaid caregivers provide
half a $billion/year in care value. US is only nation where health care of
family member is number one cause of personal bankruptcy.
This will be a really long blog if I go into that level of
detail on every presentation. So here is
my attempt to distill a number of sessions into a few key takeaways.
- Session on funding
for prevention and treatment of substance use disorders shared what some
funders feel should be priorities: parent engagement, prevention/delay of early use, brief and early
interventions. A speaker that hoped to
reduce some of the resistance to harm reduction strategies said something that
stuck with me and I'll paraphrase: "The
folks that show up at needle exchanges really want to get help, want to get
better." If you want to get at root
causes of adolescent substance abuse, trauma is a big part of the conversations. Substance abuse is anywhere from 4-9 times
more likely where there is a trauma history. Speakers from New Hampshire were open about that state's problems. The state was the first to have overdose deaths
surpass traffic fatalities. Medicaid
expansion under the Affordable Care Act (ACA) got bipartisan support in New
Hampshire, largely because the ACA mandates substance use prevention and
treatment and was seen as a way of funding responses to the the profound
problem of heroin/opiate addiction in the state.
- Head Start classrooms
in Missouri are piloting a new trauma model. Head Start Trauma Smart, developed by the Crittenton
Children's Center in Kansas City, could bring trauma informed practices to
preschool classrooms. Presenters cited
the figure that every dollar invested in early child care returns $11.
- Session on building healthy communities with a focus on
youth/intergenerational leadership, with examples drawn from programs in San
Antonio, Texas. The big takeaway was
that a healthy community initiative that doesn't include youth voices is not
going to fully reflect community perspectives.
- The second day's plenary was about community development on
a Lakota Nation reservation in South Dakota (a reservation the size of
Delaware). Improvements to housing
conditions and enhanced community resources really reflected culture and
grassroots interests by valuing community members over developers/architects in
the planning process.
- Failapalooza. A
session so named because it featured lessons learned from projects that didn't
turn out so well. A number of projects
went south due to complacency around grantees that had a good track record but
were less well suited to the task at hand. Presenters talked about extracting meaningful insights while licking
their wounds. I think this session
missed the opportunity to celebrate grantmaking that reduces the stigma of
failure by encouraging openness and a spirit of experimentation. There's
another blog topic.
So about the music. I
was able to get to the Elephant Room and catch two sets from the Jitterbug
Vipers, a staple of the Austin scene. Great fun! Witty, mostly original
songs (though a Billy Holliday cover was excellent) that crossed sultry swing
era vocals with somewhat spaced out gypsy jazz. Strong ensemble that embodies the "keep
Austin weird" ethos. That's Slim Richey, guitarist for the Vipers,
in the photo accompanying this blog.
Photo by David Weaver / Do512
Flickr: Trailer Food Tuesdays at The Long Center
Creative Commons 2.0 Licensed