Connecticut Health Foundation (CT Health) grantee* Community Health Center, Inc. (CHC) has participated in GKAS for the last seven years, but on February 3, 2012 they decided to do something different. This year, all eight of their dental sites participated by dedicating their services to children and, making it a statewide effort.

Charise DiPierro, MA, is Program Manager Mobile Dental and Community Wellness Programs for CHC, as well as a participant in the Class of 2012 CT Health Leadership Fellows Program. She is the coordinating forced behind GKAS at CHC.

Jenn: Describe the event and what happens.

Charise: At our dental sites, GKAS day was not very different than any other day, except that we dedicated all of our services to kids. We also worked with dental providers in the community who committed their time, services, and staff to seeing a certain number of children in their own dental offices.

For this event we provide comprehensive services including cleanings, sealants, x-rays, dental exams and restorative treatments (fillings and extractions).

Not only did we expand the event to encompass all of our sites this year, we also tried to make it fun. At Commodore MacDonough Elementary School in Middletown, we combined GKAS with our Recess Rocks! program. Our Americorps members created exercise routines to songs about, for example, brushing your teeth. The kids had a great time moving around (and learning about their teeth).

Jenn: What was the impact of GKAS this year?

Charise: We were able to see quite a few kids. In our community health centers and mobile dental sites, we saw almost 200 kids. Our mobile sites included Oval Grove (a collaboration with the VNA), The YWCA of New Britain, and New Britain High School.  In addition we were able to support scheduling efforts for the community dental providers who were able to see an additional 30 to 40 children. We’re pretty pleased given this the first time we’ve made this a statewide effort.

Jenn: Once the kids are in the chair, so to speak, how do you convince them and their families to prioritize oral health?

Charise: We know that oral health is not the foremost issue in everyone’s mind. We do want our patients to understand the importance of good oral health care and the impact that oral health has on overall health. We consider education a critical and complementary piece of GKAS. During both hygienic and restorative work, providers talk to patients and their parents about caring for their mouths, although the conversation can be a little different based on the work they’re having done.

Jenn: How does GKAS day change systems?

Charise: On its surface, a one-day event doesn’t seem like systems change (which I’m learning more about through the fellowship). It’s a great event that provides access to a lot of kids – but then what?

The GKAS slogan is, however, “more than just a day.” Over the seven years CHC has been involved in this event, we have seen that the need for this kind of event has gone down. Fewer kids need one stop access to care, because more kids now have access to a dental home, paid for either through HUSKY or private insurance.  Even uninsured families are given affordable options to access dental care.

The way I think GKAS changes systems is that it continues to shine a light on the issue of access. While the need has gone down, there are still kids without a dental home, without insurance, who can’t get access. If we’re still having kids that need a day like GKAS to get the oral health care that they need, this issue has not been resolved. Period. I think that these kinds of event can ultimately help to inform policy changes at a higher level by bringing attention to the topic.

*CHC is a grantee of the foundation but for different programs. You can explore our grants database to learn more.

 **Photo used courtesy of CHC.

Senior Program Officer Elizabeth Krause commented on the disparity related to Myriad. From the article:

“Elizabeth Krause, senior program officer at the Connecticut Health Foundation, which works to combat racial and ethnic health disparities, said Latinos, as well as other minorities, face multiple barriers to accessing preventative breast health care, including a lack of both health insurance and “health literacy” in understanding genetic testing options.

“A Latino woman would first have to understand her family history and then contact her insurance company to see if the test is covered, and then weigh the cost-benefit” of genetic testing, Krause said. “There are all the barriers in the world” to accessing BART or BRAC testing.”

Read the entire article here.

Today’s post was written by Lina Paredes, Vice President of Program at the Connecticut Health Foundation.

The grant application process. We recognize that applying for a grant with us (or any other funder, for that matter) can feel a bit like jumping through hoops. It requires much thinking, strategizing with your colleagues and partners, and information gathering. And that’s before the writing process even begins!

Of course, the more work you do ahead of the writing, the simpler the grant preparation process is. But what else are we looking for in a grant proposal? I’m going to shed some light into what we think makes for a strong proposal – because it actually makes us a lot happier to say “yes” rather than “no” to a request.

1. First, the basics. Make sure you fill out the proposal completely, and supply all requested information. Stick to the page limit, and answer the questions explicitly. When you don’t follow the instructions, you not only frustrate your reviewers … you leave them with the impression that you don’t have the complete answer or have  thought through your plan.
2. Alignment. You have goals you want to achieve – and so does CT Health! We exist to achieve our mission and strategic objectives via our theory of change. All three pieces of that last sentence are equally important to us. The more you can demonstrate that there is a match between what you’re trying to do and what we’re trying to do, the more we’ll want to fund your work. We take alignment very seriously, so if you get questions from us about alignment, realize part of what we’re doing is ensuring that we don’t put you through additional hoops if there’s not a match.
3. Thoughtfulness & thoroughness. Once you’ve made sure there’s real alignment between your work and that of the foundation, next you’ll want to make sure that the proposal itself is aligned and that its various parts tell a part of the same story. Or to put it another way, you don’t want to contradict yourself between sections. Besides synchronizing these pieces, you’ll want to make sure each piece demonstrates effective analysis and thorough explanation.
4. Match the budget to the strategies. We want to be able to trace the activities outlined in the narrative to the items in the budget. Make sure the words and the numbers match   Also, having a realistic budget is critical – don’t overload your budget with extras on one hand, or overpromise what you can deliver on the other.
5. Cultural & linguistic competence. For a definition of cultural and linguistic competence, please check out this article (editor’s note: based on the conversation we’ve had about this internally, you can look forward to a future blog on this topic). For us, it’s not enough to say, for example, that someone at your organization speaks Spanish. We want to see that you have an institutional commitment to this competence, demonstrated  by how you’ve embedded it within your protocols and policies. We also want to see evidence of it in your proposed work.
6. Organizational Capacity. We don’t just evaluate the project you’ve proposed, we also look at your capacity and ability to do the work. You want to explain how your organization has the experience, staff, infrastructure, partnerships and relationships that make you the appropriate organization to do this.
7. Sustainability. We’re interested in funding work whose impact will live beyond the life of the grant. How will the work continue once the grant has ended? And, how will your organization embed what you learned from the grant into your ongoing work? If you can describe both of those things, we’ll feel confident that this is a sustainable project that can make a real impact on systems in the long run.

Our proposal review process involves multiple people (sometimes outside of CT Health), and these are the things we think about. Did you find this helpful? Or do you have other questions for us about what we look for? We want to be as transparent as possible about what we’re trying to accomplish.

You can hear more here. Elizabeth’s interview starts at 48:53 minute time. Click on the audio icon and slide the bar to 48:53.

Meet Stephanye Clarke, a Connecticut Health Foundation (CT Health) Leadership Fellow from the class of 2010. Stephanye is a Health Program Coordinator & HIV Prevention Educator at the Ledge Light Health District.

When she began the fellowship in September 2009, she also became involved in a project at Ledge Light involving the Thames River Apartment Complex. The apartments primarily house residents of extremely low income, and were intended to be transitional housing. Now, however, those buildings are approximately 50 years old, and they have become intergenerational, with grandparents, parents, and children all living in the buildings.

Stephanye worked with the residents to discover which social determinant of health they’d like to prioritize. They chose environmental exposures. Now the residents and Ledge Light are working with housing and the community to create recommendations for policies that would improve their health.

In this video, Stephanye discusses how the CT Health Leadership Fellows program empowered her in this project.

I (Jenn) had the pleasure of getting to know Stephanye because she connected with CT Health on Twitter. Not only does Stephanye use Twitter to build public will for health equity, she also attends the #hcsmct (that stands for health care social media connecticut) tweetup, which takes place monthly, and the weekly twitter chats, which take place 3PM EST on Mondays. Get to know Stephanye on Twitter here, and if you’d like to join a friendly group that discusses health, health care, and social media, tweet us with the hashtag #hcsmct ! (And if you don’t know what any of that means but would like to find out, email me at jenn at cthealth dot org).

Today’s guest post was written by Yolanda Wilson, Office Manager at the Connecticut Health Foundation.

As the Officer Manager here at the Connecticut Health Foundation(CT Health), I have a lot to do. I keep the books, process payroll, supervise employees, maintain and manage all the office equipment, and provide administrative support to the board – just to name a few.

I’m also the day-to-day support person for technology issues that arise. And if there’s one thing we know it’s that technology issues ALWAYS arise. You can have the latest-and-greatest, but technology will find a way to glitch when you least expect it. And here I had thought technology was supposed to make our lives easier.

I’ll be honest:   Tech support is part of my job and I really enjoy it because there’s so much to learn, and it gives me the opportunity to grow my skill-set. But I’ll be honest again: it can also be time-consuming! Here’s how a busy woman like me balances everything.

• Love what you do. The right mindset is everything. Looking at the rapidly changing world of technology could be overwhelming, but I embrace it. I have a saying – be like water and go with the flow. Sometimes it’s smooth, sometimes there’re ripples, and then there are the rocks.  Do you go around the rock, or over the rock? Being flexible about the inconveniences of life makes it easier.
• First things first: solve the problem. If your colleague is having a tech problem, don’t over think it, just get our colleague up and running. Later, you can learn more about what happened and why.
• Just call me Nancy Drew. Meaning, think like a detective! And think of yourself as a detective too. Solving technology problems is just that: problem solving.
• Use your resources. Like me, you probably have a wealth of resources at your disposal: staff, consultants, internet searches, magazine articles. Use them. I also love NTEN and TechSoup.org. Don’t be afraid to ask questions or ask for help. Hey, I’m not afraid to admit I read For Dummies ! (And please let me give a shout out to my IT team of Carol Pollack, Hugh Brower, Michael Pelletier, and David Hale who have taught and helped me so much).
• Put your software to work. Are you really getting the most out of your technology? For example, I use the heck out of some Microsoft Outlook colored labels. Red is for urgent, and everything else is broken out by activity. This system really helps me prioritize, organize, and stay productive.

We’re on an exciting journey with the rapidly advancing world of technology, but it can be scary sometimes too. Which brings me to my most important tip: don’t forget the espresso and the deep breaths.

What do you do to keep technology working for (and not against) you?

As you can probably imagine, a lot can happen in ten years. Since CT Health was launched in 1999, we’ve awarded more than $45 million in grants and worked tirelessly to affect change in our priority areas of children’s mental health, health policy/advocacy, oral health, and racial and ethnic health disparities. In this video, both Carol and Monette discuss how they’ve seen CT Health grow, and what accomplishments along the way they’re most proud of.

Surprise bonus footage at the end! Thank you Carol and Monette for your ten years of service for CT Health.

CT Health Leadership Fellows Class of 2011

Today we’re on the Pulse + Signal blog, which is run by Andre Blackman. His blog is dedicated to how technology and new ways of thinking can impact the field of public health.

Elizabeth Krause, Senior Program Officer and Director of the Health Leadership Fellows program, and Jenn Whinnem, Communications Officer and Class of 2012 Fellow, guest on Andre’s blog to talk about the Health Leadership Fellows program and why you should apply to be a part of this competitive program.

Andre is someone we met through Twitter who offered to let us write for his blog about the program. Thanks Andre!

Don’t forget to read the blog here.

Now in its fifth year, CT MOM expects it will see 2,000 patients during its annual two-day clinic, which is being held March 23-24 in Danbury. The clinic was put together specifically to help the unserved and underserved get the dental care they need.

This event takes extensive coordination and many volunteers. Last year, they had 1700 volunteers, 900 community volunteers, and 800 professional volunteers.

In this first video, CT MOM co-chair and CT Health board member Robert M. Schreibman, DMD discusses what they’ve seen at the Mission and the care they provide. People even come from other states to get their teeth taken care of.

Of course, at CT Health, we’re interested in systems change. How does CT MOM, a two-day event, promote systems change? Here Bob discusses how they make oral health a priority for policy-makers.

CT MOM is a grantee of the Connecticut Health Foundation (CT Health).

Why do we try to change systems? As we talk about in our theory of change, the Connecticut Health Foundation (CT Health) wants to improve the health of state residents through changing systems. If we can change a system, we won’t just help one person, we’ll help hundreds, and improve health outcomes for future generations. That’s why a majority of our investments have a systems-change approach.

But what does a systems-change approach really mean? In the abstract, it’s not an easy concept to understand. So that’s why we’re taking a look at our grant to the Smiles for Life (SFL) curriculum to provide an example. SFL is a national oral health curriculum designed to teach primary care practitioners about the importance of good oral health – and is also a great example of systems change.

Changing Systems in Oral Health

At CT Health, we know that oral health is part of overall health. Research is clear that poor oral health can lead to problems with overall health such as cardiovascular disease, diabetes and low birth weight.

And yet our current health system separates the mouth from the body. This divide is most clearly seen in how dental insurance coverage is separate from medical insurance coverage and often is purchased and paid for separately.

Part of linking these two systems together involves educating primary care doctors on the importance of oral health so that they can educate their patients. The best way to integrate oral health into medical health is to reach doctors while they are in residency training.

“Habits learned during residency are the ones that stick with physicians,” says Joanna Douglass, BDS, DDS, CT Health oral health consultant and one of the original creators of SFL in 2005. “Even if a physician learns a new way of doing something later on, their preference is to return to the old way. Physicians that learn about oral health early will keep promoting it in the years to come.”

By educating current and future medical providers about the importance of oral health,  oral health champions can be created in other professions.

To Change a System, Start Small

SFL didn’t start off trying to change the entire medical educational infrastructure – it started with family medicine.

Back in 2004, some family physicians, a PhD educator, and a pediatric dentist, formed a work group within the Society of Teachers of Family Medicine, an academic association. This group was building on work funded previously through grants from a federal agency, the Health Resources and Services Administration. The goal was to put together an oral health curriculum for medical providers.

“As a residency director, I can tell you that if you make this kind of training mandatory, but then don’t give the faculty something to work with, you won’t make much progress,” says Alan Douglass, MD, one of the original creators of SFL. “Giving the faculty an easily accessible tool was a critical component of our success.”

CT Health, with other funders, funded the initiative to develop the actual curriculum. The first version was available only on CD-ROM. Later on, the SFL training was made a requirement of family medicine training at 460 medical residency programs across the United States. Now, SFL is available on the Smiles for Life website. More importantly, it has been expanded to include individual physicians, physician assistants, nurse practitioners, students, and other clinicians. The courses are free and count towards continuing medical education credits.

And Beyond

More recently, the Boston-based DentaQuest Foundation has spearheaded the creation of the National Interprofessional Initiative on Oral Health (NIIOH), which will take SFL to the next level. According to their website, NIIOH is “a consortium of funders and health professionals whose vision is that dental disease can be eradicated.” Not only is NIIOH disseminating SFL into other disciplines, it’s also bringing together different accreditation bodies, as it is these organizations that shape educational standards.

While we can’t say that this program alone will reconnect the mouth with the body, it’s definitely a great start.

Photo by Miss Millificent used under the Creative Commons license.