Meeting the VNA Mission through Community Partnerships

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4 Meeting the VNA Mission through Community Partnerships Th e National Institutes of Health recently directed researchers to work in partnerships with communities to try to bridge the 20-year gap that typically exists between the time research data is collected and when it is actually translated into practice in the community. Although not a research institution, VNA has a long history of community partnerships. Th rough these relationships, we work hard to ensure that the translation of outcomes from a project we funded does not take 20 years to be utilized in another setting. VNA takes steps Julia Muennich Cowell PhD, APRN BC, FAAN, Chair to encourage the careful reporting of outcomes and the dissemination of successes and challenges we have encountered to subsequent applicants and peers. A primary focus of our collaboration with community partners is sharing outcome measurement methodologies our grantees have utilized. VNA is very proud of our partnership reputation in the community. We recognize the fact that our community partners have expertise in diagnosing and planning for the communities they serve. To support and capitalize 1

5 on this expertise, VNA funds services that are basic to a healthy life, and we frequently facilitate linkages to maximize impact. Our relationship with Lawndale Christian Health Center is one good example of partnership. The Center, embedded in an underserved community, requested and received funding to support a chronic care management model. Finding the right nurse to oversee the program proved challenging, however, so to help, VNA brokered an introduction to an outstanding new nurse and one of the first VNA scholars, Arthur Hackett. Today, Mr. Hackett supervises the chronic care program that tracks more than 2,000 patients with hypertension and dyslipidemia. VNA is also proud of our nursing initiatives. Recognizing the long-term negative impact of the nursing shortage, particularly in community/public health nursing, we designed two programs that address the problem. The Super Star in Community Nursing Award, now in its sixth year, recognizes and publicizes the accomplishments of community/public health nurses through a $25,000 cash award to an outstanding front-lines community health nurse. Our pool of nominees for the 2007 Super Star Award was outstanding, and, in addition to the winner, five finalists were selected for recognition. Our second nursing initiative, the VNA ABSN Scholars program, was developed after some of our grantees told us about difficulties finding the right nurses to staff their programs a problem we recognized as another reflection of the nursing shortage. Under this program, VNA provides two full-tuition scholarships for nursing students in accelerated baccalaureate programs who are committed to launching their careers in community/public health nursing. Begun only last year, we have been impressed by the quality of the scholars, each chosen by their faculty, and have great hope that future scholars, like Mr. Hackett, will have important impact on the health of the communities they serve. As we begin our second decade of grantmaking, I reflect on our first baby steps toward establishing our grantmaking guidelines, learning to evaluate proposals, and looking for staff to carry out our mission. We are so fortunate to have an experienced and enthusiastic staff committed to maximizing our community partnerships and a board which is unwaveringly committed to enhancing health services for the medically underserved. We will continue to try to grow our potential to contribute to community solutions through financial support, and we are proud to be able to share our expertise with community health providers and fellow grantmakers across metropolitan Chicago. 2

6 Focusing on Outcomes and Sharing What They Have Taught Us If you are reading an engrossing and entertaining book, do you continue reading it to the end rather than stopping in the middle of the story? If you discover a new procedure or approach that would improve your organization s effi cacy, do you share your newfound knowledge with colleagues rather than keeping it a secret? Th e obvious answer to both these questions is Yes! ; however, each day some funders make, in effect, the opposite decision. Th ey direct resources towards Robert N. DiLeonardi, Executive Director exhaustive analysis of initial grant requests, but pay far less attention to grant outcomes. Th ey know a lot about the beginning of the story, but little about the end and isn t the ending usually the best part? And even when grant outcomes are tracked, too often results and progress reports are sentenced to solitary confinement in a dusty file cabinet in a 3

7 foundation s back office. In short, sometimes grantmakers focus too much effort on making grants, and not enough on what actually happened as a result of the grant. That s why at VNA Foundation we try to direct at least as many resources to understanding the ultimate impact of a grant as were spent on pre-grant analysis. Significant portions of each VNA board meeting are spent on post-grant reporting and analysis, either by type or purpose of grant (e.g., in-depth reports on maternal-child health grants or home visiting programs) or simple chronology (e.g., the results of all the grants approved between August and May of last year). We believe these reports (which also include regional and national statistics and background information to place our grantmaking in context), along with presentations from expert speakers, add an invaluable rest of the story component to our grantmaking process. Making the grant is often just the first step on a long and interesting journey, so we believe that a focus on outcomes and end results and especially the opportunity to examine and discuss grant outcomes at meetings that include both board and staff is time well spent. The educational and informational benefits of these reviews have become evident, and they have positively impacted our grantmaking. We also believe that we have a responsibility to inform more than just ourselves. Via this report and especially via its companion website, we seek to share our findings with others who are interested. Philanthropy is a field perhaps not best known for a continuing emphasis on the dissemination of findings. The scenario of every small or midsize foundation around the country each re-inventing the wheel is one we work hard to help avoid. We hope that you will take a moment to read this annual report, or visit as we attempt to share what we ve learned over the years about making grants to assist the medically underserved. Perhaps some of our successes and missteps can aid other funders in their grantmaking decisions and more nonprofits in their program development. outcomes 4

8 After more than a decade of grantmaking focused on nurse-delivered community- and homebased health services, VNA believes more firmly than ever in the effi cacy of these methods of providing care to the underserved and the importance of preserving them. Th esuper Star in Community Nursing Award and the ABSN Scholarship Program are intended to acknowledge the service that Public Health/Community Health nurses provide, recognize the value of nursing in the community, help attract young people to the profession and contribute to efforts to decrease the nursing shortage. 5

9 Exceptional Nurse Receives $25,000 and Named Super Star Among Chicago Area s Community Health Nurses Th e VNA Foundation recognized Sally Lemke, RNC, MS, NP as the 2007 Super Star in Community Nursing for her commitment to the medically underserved in Chicago s west side Austin neighborhood. Now in its sixth consecutive year, the Super Star distinction was awarded to Ms. Lemke and five finalists, all nominated by their peers and selected by a panel of healthcare and nursing experts. Th e award not only recognizes the significant contributions of these nurses, but also seeks to encourage more talented young people to consider public/ community health nursing as a career choice. Sally Lemke RNC, MS, NP About the 2007 Award Winner Sally Lemke decided early on in her career that she wanted to make a difference. After receiving a Bachelor of Social Work at Central Michigan University, she spent three years in the Peace Corps in Central African Republic. As a health educator and trainer, Lemke helped develop national health education curricula, as well as a pilot program to introduce health and hygiene concepts to help African women. After her Peace Corp stint, Lemke continued working with the medically underserved, this time caring for chronically mentally ill patients through a community-integrated vocational rehabilitation program. Th is experience, coupled with her time overseas, crystallized Lemke s decision to make a difference by pursuing a career in community health nursing. In 1993, Lemke received her R.N. from the University of California in San Francisco (UCSF). She then continued her training within the school s graduate program, earning her Master of Science in Nursing with an emphasis on women s primary care in Th at same year, Lemke was awarded the National Health Service Corps Scholarship that recruits primary care providers to medically underserved areas throughout the United States. Th at scholarship led her to the south side s Chicago Family Health Center. Th ere she provided obstetric and gynecological care to a multicultural 6

10 community and also served on a mobile health care team serving the homeless. After four years at the center, Lemke joined the University of Chicago Hospital s Women s Center where she continued to care for women. She designed and implemented a clinic-wide pap tracking system and also served on the hospital s Women s Health Education Council. From , Lemke was employed at the Friend Family Health Center continuing her care of the medically underserved women of Chicago.! Lemke s most memorable and meaningful work, however, was accomplished during her recent role as the Nurse Practitioner at the Austin Health Center of Cook County, part of the Cook County Bureau of Health Services. Over the past two years, Lemke created and implemented one of the center s most successful programs by utilizing the Centering Pregnancy model of group prenatal care. Lemke is rightly proud of the quantitative results of the program and its positive impact on birth outcomes: the program recorded more than 100 successful births and demonstrated a reduction in low birth-weight babies and increases in breastfeeding rates. The program also achieved significant decreases in caesarean-section delivery rates a rate just one-third of the national average. Shortly after receiving the Super Star Award, Ms. Lemke s position became entangled with the funding cuts at the Cook County Bureau of Health Services, and she was forced to leave her position at the Austin Health Center. As an experienced nurse with an advanced education, Ms. Lemke knows she will find other meaningful employment. She worries, however, about her patients and the Centering Pregnancy Program that she regrettably left behind. I love my work and I m very proud of receiving this honor from the VNA Foundation, said Lemke. I learned a long time ago in the Peace Corps that a lot of small contributions add up to a greater good for all. I know that I m in the company of a lot of fantastic public health nurses throughout Chicago that are making a difference in the lives of the medically underserved. Shocked and thrilled to receive the $25,000 unrestricted cash award, Lemke plans to save the majority of her prize for her sons college fund, but also plans to treat a few deserving colleagues that have mentored and supported her along her career. For the past five years, the VNA Foundation has acknowledged the incredible service and many contributions of community health nurses. This year s candidates were equally exceptional, but Sally Lemke s journey to become a public health nurse was particularly inspirational, and her impact well-demonstrated. VNA is honored to call her our 2007 Super Star. 7

11 About the 2007 Super Star in Community Nursing Award Finalists Th e VNA Foundation also awarded five Super Star finalists unrestricted $2,000 cash awards for their exceptional efforts in community nursing: Jehan-Marie Daley Adamji, RN, BA, BSN Public Health Nurse, Orr Health Center, Rush University Medical Center Ms. Daley Adamji was hired as the Public Health Nurse at the Orr Health Center in March of She is a staunch advocate for her patients and works with the Illinois Coalition for School Health Centers to increase funding from the state. In addition to her work in the health center, Ms. Daley Adamji established and coordinates the Orr Campus Health and Medical Practices Society, provides clinical instruction for nursing students, and is the assistant coach for the Orr girls basketball team. Suzanne J. Barker, RN, BSN, ILCSN District School Nurse and Health Services Coordinator, East Maine School District 63 Ms. Barker has spent most of her career in school nursing and for the past year has been employed by the East Maine School District 63 as the Health Services Coordinator. Ms. Barker supervises seven health clerks at six elementary and one junior high school, ensuring that all students receive care, services and follow-up. Ms. Barker also instructs the teaching staff and parents and continuously seeks resources for her schools. Ms. Barker is currently enrolled in a graduate nursing program at West Suburban College of Nursing and has been selected as a Chicago Area Schweitzer Nursing Fellow for the academic year. Lenora Pizzello, RN, BSN, MS Sanctuary Place Nurse, Interfaith Council for the Homeless, Rush University Medical Center Ms. Pizzello has a long history of service to the community and currently works at Sanctuary Place, a permanent housing community for women and their children, and a community practice site through 8

12 Rush University College of Nursing. She is also a clinical instructor for undergraduate students within the Department of Community and Mental Health Nursing. Ms. Pizzello s clinical excellence is evidenced by her individual and population based interventions and her practice style which blends preventive and case management models of care, including linkages to primary care, chronic disease management, and psychiatric services. Michele Shubitowski, RN, BSN Director, Erie Teen Health Center, Erie Family Health Center Ms. Shubitowski has worked at the Erie Teen Center for 18 years. For the past 7 years, she has managed all of its operations, while maintaining a strong direct clinical role, including Title X grant management. She is considered Erie s clinical expert on adolescent health, while also exhibiting a unique ability to communicate with young people and implement services and programming that reach teens. Ms. Shubitowski s knowledge is paired with a commitment to her adolescent patients, continually striving to ensure their right to receive quality, accessible health care. Sally Wagoner, RN, BSN Director, Wellness Center, American Indian Center Ms. Wagoner has many years of experience in home health nursing, and since 1999 has worked with the Chicago area s American Indian community. As Wellness Director for the American Indian Center, Ms. Wagoner oversees a number of outreach and screening activities. She has brought a holistic wellness approach to her activities at the AIC and in the Chicago Native American community and has sought to put health and wellness information and practices from the dominant culture into a co-creative relationship with the beliefs and traditions of American Indian people. 9

13 One of the objectives of VNA s Super Star in Community Nursing award is to generate press coverage of the winners and the work they do, thereby drawing attention to community/public health nursing as a career choice. In past years, our Super Stars have been mentioned in newspapers, featured in magazines, interviewed on radio and asked to speak at graduation ceremonies. 10

14 Nothing could have prepared us, however, for the avalanche of media attention foisted on this year s winner, Sally Lemke, RNC, MS, NP. Just days after receiving her award, Ms. Lemke was forced to leave her position as community health nurse practitioner at the Austin Health Center of Cook County, one of the many casualties of indiscriminate budget cuts by County politicians. Todd (Stroger) Cuts Nurse of the Year was the front page headline on the July 19, 2007 Chicago Sun-Times, and that morning the phone at the VNA office rang almost nonstop as we fielded calls from the media. The story really took off, however, when Governor Rod Blagojevich s office contacted VNA to say that the Governor had read the article and wanted to call Ms. Lemke to offer her a job with the State of Illinois. At noon that day, virtually every local TV station, along with three radio stations and two newspapers, gathered outside Ms. Lemke s office as she took a call from Governor Blagojevich. Stories on this phone call from the Governor appeared on every local news broadcast that evening, and many of the station websites had coverage as well. The following day, United Press International picked up the story and it appeared in several out of state papers. Throughout it all, Ms. Lemke was poised and articulate, quietly demonstrating by her actions during each interview some of the qualities that led to her selection as a Super Star winner. Perhaps most importantly, however, she showed an impressive determination to focus on the positive outcomes from her work with at-risk mothers and concern for the welfare of vulnerable patients left behind in the wake of County budget cuts, rather than her own predicament. Like so many other community/public health nurses, Ms. Lemke provides a strong and inspiring example of leadership and commitment even under the most challenging circumstances. 11

15 Strengthening Our Commitment to Nursing and the Needs of the Medically Underserved Our newest nursing initiative promotes the training of qualified nurses who can provide community and public health services to people in need. Last year we introduced the VNA Foundation ABSN Scholars Program as another way to encourage the careers of nurses who choose to practice in community- and homebased care. Under the ABSN Scholars program, grants are awarded to the Loyola University Neihoff School of Nursing and the Rush University College of Nursing. Faculty at each school then select an outstanding post-baccalaureate student enrolled in the school s accelerated BSN program, and the student is awarded a scholarship funded by the VNA to pay for tuition and fees. In return, and per the terms of the scholarship, each recipient agrees to work for two years following graduation in a community- or home-based service agency in the metropolitan Chicago area. Both 2007 ABSN Scholars have extensive experience in community-based services, and both bring maturity and dedication to their nursing preparation. We are delighted that these two women are recipients of the scholarships, and certain that as community and public health nurses, they will help to ensure that the full range of quality healthcare services are available to all. Selected as the 2007 VNA Foundation ABSN Scholars are: M. D G - Rush University College of Nursing M. J M - Loyola University Neihoff School of Nursing 12

16 VNA requires measurable outcomes from its grants, some kind of objective and quantitative indication of the impact good, bad, or none of our grant dollars. Outcomes help us to determine the effectiveness of the programs funded by our grant dollars and to identify successes, challenges and barriers so that we can share this information with others. Th ey also help us to better focus our grantmaking, ensuring that our grant dollars are making a positive impact on the underserved communities we strive to assist. Summarized in the following pages are the collective outcomes for two types of grants frequently funded by VNA since its beginning eleven years ago. We hope that, by sharing this information, we can help both grantseekers and grantmakers to consider the proven successes of these basic programs that our grantees have skillfully evolved into effective interventions. More information is available at 13

17 Home Visiting Programs Sixty-five grants, totaling $3,106,446 or 16.5% of all VNA grants, have been awarded to support programs that provide exclusively or primarily home health services. About 2/3 of the grants served maternal-child, family or senior health; the remaining grants funded chronic illness management and education programs, services to adults with disabilities, and hospice/palliative care. Eightynine percent of grants supported a home visiting nurse, doula or other home visiting personnel, and remaining funds went to supplies and equipment. Maternal-child and family health grants provided prenatal services, high-risk mother and infant care, and early childhood care. Measurable results from these grants included reductions in premature births, low-weight babies and incidences of domestic violence during pregnancy. Also reported were increases in breastfeeding initiation rates, well child visits and immunizations. Clients in these programs particularly teen mothers also made improvements in parenting ability, life course development, self-suffi ciency, and ability to access supportive services. Senior health and homebound grants addressed the growing need for home visiting services attributable to the aging of the general population, and in particular, the number of older and sicker seniors who hope to remain in their homes. Positive outcomes included improved detection of previously undiagnosed illness like depression and dementia as well as slowed disease progression. Also reported were improved health outcomes due to earlier intervention, better adherence to nutrition counseling and medication regimens, and improvements in activities of daily living that allowed clients to live longer and safer at home. 14

18 Other home visiting grants showed results that were more mixed. For example, programs that provided home visits to chronically ill non-senior adults sometimes had difficulty accessing patient homes, and patient adherence to instruction and referral proved challenging due to lack of insurance, transportation problems and other barriers to care that often impact medically underserved populations. Grants to programs for adults with disabilities were successful, however, when utilizing a nurse dedicated to providing care to a limited number of people residing in group homes or supervised facilities. Outcomes for grants in support of hospice and palliative care also demonstrated basic success, achieving their simple but important goal of increased access for impoverished populations. What Was Learned: Grantees learned that the evaluation required by VNA helped them to better track and assess patients seen in their programs and to identify strategies (such as case finding) to increase program utilization. Outcome tracking also helped to determine barriers to care and sometimes resulted in other health professionals with different skill sets participating in the program. Finally, outcome measures also provided a valuable representation of the intensity of care needed to serve a group of high-risk patients and formally demonstrated that patient trust and satisfaction can be increased by responding quickly to family needs and maintaining a person-centered approach to care. VNA learned what methodologies and approaches generally netted the best results, and was able to share that knowledge with applicants and fellow funders. These findings were then used to better inform grantmaking decisions and replication efforts. 15

19 PROGRAM S THAT SERVE THE HOM ELESS Sixty-six grants have been paid totaling $2,473,849, or about 13% of all VNA grant dollars to programs providing health services to the homeless. Programs that served adults received 26% and programs that served various ages and families received 33% of grant dollars. Almost one-half of the services to homeless populations were provided through clinics or on-site in shelters and supportive agencies, and the remainder were offered through outreach and mobile facilities. About one-fourth of the programs were nurse run. Programs providing direct healthcare to homeless populations offered primary care including chronic disease management, psychiatric, and dental and vision services. Health education and health promotion were also commonly provided, as were support services such as housing assistance, case management and referral. Results from all agencies showed generally positive outcomes and most objectives were achieved. Depending on the depth of interaction with clients, programs were sometimes able to provide additional infectious disease screening, monitoring of immunization status (particularly among children), and assistance with adherence to self-medication. Clients served by the programs also demonstrated improved compliance with referrals to specialty care services and medical service plans, and increases in knowledge of health issues, preventive behaviors and self management. In addition to the direct benefits to clients, these services helped to relieve the burden on hospital emergency rooms and to better document the needs of homeless populations. 16

20 What Was Learned Grantees learned that health is often not a priority for homeless populations, so agencies must remain realistic when setting goals. When delivering care, models that utilize on-site delivery, at a place where trust and rapport had already been established, work well. Evaluation is particularly challenging with this generally mobile and disconnected population. Grantees emphasized that the homeless population is diffi cult to track and lack of trust makes open, honest communication diffi cult in both individual and group settings. New privacy laws, although helpful in other contexts, have made it even more diffi cult to follow patients between agencies. Despite these challenges, however, evaluation data is worth pursuing as it helps to strengthen funding bases and increase resources, and perhaps most importantly, to improve services to this very underserved population. VNA learned what staff and board had intuitively suspected was in fact true: when serving the homeless, the location and delivery style of care were among the greatest contributors to program success. In addition, we were reminded that, although sweeping impact was sometimes possible, small victories were more likely to occur and to be celebrated. 17

21 VNA Foundation FY 07 Grants AIDS Foundation of Chicago $50,000 For a nurse to provide intensive, home-based services to residents of supportive housing on the South Side. Alivio Medical Center $19,700 To support the Centering Pregnancy model of care at two community-based clinic sites. American Indian Center $47,360 Toward outreach, screening, health education and referrals for American Indians. The ARK $33,000 Toward a part time nurse who serves as the Clinical Manager at its free clinic. Asian Human Services Family Health Center, Inc. $20,000 Toward a Nurse Coordinator to assist immigrants and refugees from Asia, and other low-income residents of the north side. Breakthrough Urban Ministries $20,000 Toward healthcare services to homeless women and families living in East Garfield Park. Casa Central $15,000 For nursing staff for a program to maximize the independent functioning skills of low-income Hispanic elderly. Chicago Abused Women Coalition $40,000 Toward direct services to victims of domestic violence, and training for Cook County Ambulatory Care providers about domestic violence screening and referral. Chicago Women in Philanthropy $2,250 General operating support. Christian Community Health Center $45,000 Toward an RN to provide direct patient care and health education to women in the Greater Roseland and Calumet City areas. Community Health, Inc. $71,500 Toward the salaries and benefits of three community health nurses at this free clinic. Concern America $25,000 To improve health care in underserved communities in the Chicago area, provide hands-on community-centered health learning opportunities and build support and capacity for community-based health care. Deborah s Place $15,000 Toward the salary of the Health Services Advocate who provides health education and follow-up services to homeless women. Delnor-Community Health Care Foundation $20,000 Toward home visits to un- or underinsured new moms and their babies. Erie Family Health Center $41,666 For oral health care for low-income children, pregnant women and adults with diabetes. 20

22 Erie Family Health Center $50,000 Toward the expansion of its Maternal Care Program, providing underserved women with high-quality, comprehensive prenatal care. Evanston Township High School $25,000 For an outreach program to extend primary care services to high-risk, often uninsured students in the elementary and middle schools that feed into ETHS. Family Christian Health Center $75,000 To hire a Nurse Practitioner to provide non-emergency immediate medical care. Fox Valley Volunteer Hospice $5,000 To recruit, train and sustain a core of Spanish-speaking volunteers, and to develop Spanish-language training and education materials. Free People s Clinic $40,000 Toward the provision of primary care services at this free clinic on the south side. Health and Medicine Policy Research Group $36,000 To fund six Albert Schweitzer Nursing fellows, post-baccalaureate nursing students who will provide service at community-based clinics and service sites in medically underserved areas in Chicago. Heartland Health Outreach $39,543 Toward nurse salaries at a school-based health center at Senn High School on Chicago s north side. Horizon Hospice and Palliative Care $35,000 Toward the salary of a nurse to coordinate the pediatric palliative care program. Hospice of Northeastern Illinois $50,000 Toward nurses to provide specialized, in home, palliative and hospice care to children with life-threatening or terminal illnesses. Housing Opportunities for Women $30,000 Toward the salary of a Patient Navigator who will help meet the health needs of the women and children in HOW s supportive housing program. Howard Area Community Center $39,361 To support the salary of a nurse at this agency serving low-income families in Rogers Park. Howard Brown Health Center $20,000 Toward the provision of health care at a center offering a variety of comprehensive services for gay, lesbian, bisexual, transgendered and/or homeless youth. Hull House Association $27,500 Toward medical case management for formerly homeless individuals and families who live in supportive housing. Illinois College of Optometry $10,000 To link medically underserved people being treated for vision problems to community-based primary health care. Infant Welfare Society of Chicago $60,000 To hire a lead nurse for its Women s Clinic in Chicago s West Logan Square neighborhood. 21

23 Interfaith Council for the Homeless $20,000 Toward the salary of a nurse practitioner to provide health services to formerly homeless women and families living in supportive housing. Interfaith House $50,000 To provide care for homeless people after they have been released from a hospital or ER. Juvenile Protective Association $50,000 To provide comprehensive parenting and mental health services to highly stressed, low-income, medically underserved families with Non-Organic Failure to Thrive (FTT) infants. Lawndale Christian Health Center $40,000 Toward a nurse and other staff for a disease management program for patients with cardiovascular disease. Marillac Social Center $75,000 To hire a Nurse Practitioner to provide primary care, home visits, chronic disease management, referrals and health education for people of all ages on the west side. Mobile C.A.R.E. Foundation $60,000 For a nurse to staff a third mobile van providing care to children with asthma. The Night Ministry $55,000 Toward a program to improve management of chronic diseases like hypertension and respiratory illness. Pacific Garden Mission $40,000 Toward the salary of a new Nurse Practitioner for a clinic serving homeless men, women and children. Planned Parenthood Chicago Area $25,000 To support its low-cost Colposcopy program. Rape Victim Advocates $20,000 To provide medical advocacy, counseling, and prevention education to survivors of sexual assault. Residents for Effective Shelter Transition $15,000 Toward medication, hygiene supplies, and patient transportation. Respiratory Health Association of Metropolitan Chicago $45,000 To provide flu and pneumonia vaccinations to the medically underserved. Rush University College of Nursing $30,932 Scholarship for a nursing student enrolled in its Accelerated Bachelor of Science in Nursing program; after graduation recipient will work for at least two years aiding medically underserved population. San Miguel Schools Chicago $15,000 Toward its Family Support Program of supportive health and social services. South Side Help Center $25,000 To hire a health educator to provide school-based programs to prevent violence and the use of drugs, alcohol and tobacco. 22

24 South Suburban PADS $31,000 Toward the continued salary support of two nurses who staff the Homeless Healthcare Network. St. Bernard Hospital and Health Care Center $75,000 Toward the salary of a Nurse Practitioner who will provide a variety of important health services via a mobile health clinic. Super Star Nurse Award $31,000 To recognize an outstanding community/public health nurse and two finalists. Teen Living Programs $65,000 For continued support of its Well Now! health program to teach homeless youth healthy living skills. Teen Parent Connection $25,000 To provide doula services to pregnant teens in DuPage County. Tri City Health Partnership $20,000 To expand operations at this free clinic in Kane county. Visiting Nurse Association of Fox Valley $40,000 Toward a capital campaign for a new medical facility. Well Child Center $30,000 For staff and supplies at a dental clinic for low-income children in Elgin. Westside Health Authority $60,000 To provide screening, health education and primary care to Austin area residents with metabolic risk factors. White Crane Wellness Center $40,000 Toward community-based disease prevention and health promotion services for economically disadvantaged and medically underserved seniors in Chicago and suburban Cook and DuPage counties. Y-ME Illinois $24,075 To provide free mammograms in underserved areas of Chicago and Cook County. Youth Guidance $18,582 For salaries and lab work at a school-based health center at Roberto Clemente High School in West Humboldt Park. YWCA of Evanston/North Shore $15,000 Toward health education provided by a nurse for residents of the Y s two programs for women who have experienced domestic abuse. YWCA of Metropolitan Chicago $35,000 To provide training about sexual assault to emergency room nurses, and for crisis intervention services to sexual assault victims visiting emergency rooms. Grand Total: 59 Grants $2,083,469 23

25 2007 Grants: Challenge and Opportunity For FY 07 VNA granted over $2 million, a welcome boost over the smaller grants budgets of recent years, but unfortunately a figure that did not change the fact that demand outstripped supply in ways that made the screening process a particularly challenging one. In FY 07 we saw both the quantity and quality of grant requests increase at a pace far greater than our budget. Th e result was a year characterized by very tough decisions on letters of intent, proposal reviews, and funding decisions. VNA has always tried to strike a balance between old and new, renewal and startup. After each round of submissions of letters of intent, we met to discuss the pros, cons and guidelines compliance of each request and prioritized the results. With extremely worthwhile, proven programs competing for the same limited dollars as unknown but often promising new endeavors, few decisions were easy. Each request was subjected to increased scrutiny and contemplation, which often translated into more frequent or lengthy site visits, more review of supporting documents, and more interchange with applicants. When all was said and done, however, we were able to fund both core grants (e.g., staff salaries at free clinics, homeless shelter visiting nurses), as well as carefully considered new ground (e.g., peer-supported prenatal program at a community health center, unique health outreach program for Native Americans). We were also able to maintain, and in some cases increase, funding for our special initiatives such as the Super Star in Community Nursing Award, Nursing Scholarships and Oral Health Initiative. As always, whatever the differences in our grants, they are bound by vital common ground: they represent our most sincere and thoughtful effort to make a meaningful difference in the lives of Chicago s medically underserved. 18

26 FY 07 Grants By Population Served CHILDREN & YOUTH 29% SENIORS 2% ADULTS 19% VARIOUS AGES 50% FY 07 Grants By Internal Program PREVENTION AND HEALTH PROMOTION 19% HEALTH CARE AND/OR HEALTH CARE ACCESS 44% HEALTH CARE AND HEALTH PROMOTION PREVENTION 37% FY 07 Grants By Geographical Area CHICAGO SOUTH CITY & SUBURBS 9% 13% SUBURBS- COLLAR COUNTIES 17% CHICAGO WEST 19% CHICAGO NORTH 15% CHICAGO CITY-WIDE 27% 19

27 VNA FOUNDATION STATEMENT OF FINANCIAL POSITION ASSETS Investments Cash Other Total assets June 30, 2007 June 30, ,912,122 59,106 22,486 55,993,714 49,254,828 30,077 17,690 49,302,595 LIABILITIES AND FUND BALANCE Accounts payable Fund Balance Total Liabilities and Fund Balance ,993,401 55,993,714-49,302,595 49,302,595 REVENUES AND EXPENSES REVENUES Investment Gains Investment Income Contributions Income Total Revenues 8,401,593 1,131,044 14,176 9,546,813 4,291,870 1,097,664 34,490 5,424,024 OPERATING EXPENSES General and Administrative Investment and Management Fees Total Operating Expenses Excess Revenues Before Other Items OTHER EXPENSES Program Grants Paid Excise Tax Excess Revenues 467, , ,498 8,875,315 (2,083,469) (114,979) 6,676, , , ,568 4,780,456 (1,988,931) (102,597) 2,688,928 24

28 GUIDELINES FOR GRANT APPLICATIONS Th e grantmaking goal of the VNA Foundation is to support home- and community-based healthcare and health services for the medically underserved in Cook and the collar counties, with a focus on Chicago. I. To meet this goal, capital, program and general operating grants will be considered which are in support of, but not limited to, the following purposes: Home healthcare services Community- and school-based services Primary care and chronic disease management Health education and early intervention II. Priority will be given to programs in which care is provided by nurses. III. All grants must: Have measurable goals and objectives. Benefit the medically underserved. Be submitted by an organization exempt from income tax under sec. 501 (c)(3) and designated as a public charity under section 509(a)(1) or 509(a)(2) of the Internal Revenue Code. VNA Foundation does not provide grants to section 509(a)(3) supporting organizations. Please attach to each letter of intent (or other initial communication with the foundation) your most recent IRS Determination Letter stating your status as a 501(c)(3) organization with a 509(a)(1) or 509(a)(2) designation. APPLICATION PROCEDURES: 1. Review carefully the Guidelines for Grant Applicants listed above to determine your eligibility for consideration. 2. If you wish to apply, contact the VNA Foundation offi ce or visit us on the web at to learn current submission deadlines. 3. Send four copies of a letter of intent of 2-3 pages which briefly describes the project or purpose for which you seek funding, including: the overall goal, the specific outcome measures demonstrating the impact of the grant (beyond just volume measures), a workplan of how the objectives are to be achieved, the identity of the key staff, the specific amount to be requested, the total time frame, and your most recent IRS Determination Letter stating your status as a 501(c)(3) organization with further designation as 509(a)(1) or 509(a)(2) public charity. Facsimiles and s are not accepted. 4. Based upon review of this letter, you will either be asked to submit two complete copies of a full proposal (including a completed Chicago Area Grant Application Form, 5-7 page narrative, budget with narrative, and attachments) or be advised to look elsewhere for funding. 5. Address the letter of intent to: Robert N. DiLeonardi, Executive Director VNA Foundation 20 North Wacker Drive, Suite 3118 Chicago, IL (312)

29 Board of Directors Julia Muennich Cowell PhD, APRN BC, FAAN, Chair Professor and Chair Community and Mental Health Nursing Rush University Medical Center Brigid E. Kenney, Vice Chair Senior Vice President/Network Operations Tribune Interactive Sue McWilliams, RN MSN, Secretary Vice President of Medical Services Interactive Health Solutions Nancy Jones Emrich, Treasurer President LilFest LLC Consultant Janet Cabot Executive Vice President and General Manager Edelman Anne M. Davis Community Volunteer Marie W. Harris Community Volunteer Dian Langenhorst Healthcare Strategist DL Enterprises Katherine H. Miller Community Volunteer Staff Robert N. DiLeonardi, Executive Director Claudia A. Baier, Program Offi cer Ann C. Schaefer, Program Associate Honorary Board Mrs. Carl A. Hedblom Mrs. Frank D. Mayer Mrs. John H. McDermott All VNAF Board members provide their time and services voluntarily and receive no compensation. 26