Funding Opportunity: Advance Care Planning
Advance care planning is an important strategy for health engagement, person-centered care, shared decision-making and achievement of Triple Aim objectives. It helps ensure that the care individuals receive in the event of incapability or at end of life aligns with their values, goals and informed preferences.
As part of the Colorado Health Foundation’s strategy to empower individuals and families to manage their own health, the Advance Care Planning funding opportunity has awarded grants of up to two years and up to approximately $200,000 for implementation of effective advance care planning initiatives in Colorado. In June of 2016, the Foundation approved $2.75 million in funding to seven geographically dispersed organizations to extend work under the Advance Care Planning initiative for three years.
Grant Deadline: Not accepting applications. This work is in progress.
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The Foundation is using Canada’s National Framework for Advance Care Planning to help guide and coordinate advance care planning efforts, and supported initiatives will focus their activities in one or more of the following domains:
- Engagement – Engaging relevant health care systems/organizations/governments, professionals, providers and the general public in preparing for and implementing advance care planning
- Education – Educating health care, legal, social service, government professionals and the general public about advance care planning
- System Infrastructure – Creating infrastructure in the health and legal systems that facilitate the engagement of organizations, professionals and the general public in advance care planning (e.g., policy and program development and tools to support conversations and documentation)
- Continuous Quality Improvement – Evaluating advance care planning initiatives in Colorado based on structure, process and meaningful outcomes indicators
This funding opportunity is designed to accelerate existing advance care planning efforts in Colorado where feasible and to support innovative demonstration projects that have the goal of increasing individual and family health engagement as a result of:
- Upstream and ongoing conversations about what matters when an individual is seriously ill or near end of life
- Selection of a fully informed medical durable power of attorney
- Receiving medical and related social services consistent with an individual’s values, goals and informed preferences
Associated Measurable Results: Applicants will be asked to indicate how their work will numerically:
- Increase the number of Coloradans who are actively engaged in their health.
The funding opportunity will include a learning plan that aims to answer key questions about the impact of advance care planning efforts on patient engagement. Grantees may also be asked to report on project outcomes, using existing data they collect about their programs. Whether grantees report on project outcomes will depend upon the type of applications the Foundation receives and whether the grantees can readily collect and report out data.
To be considered for funding, proposals described the extent to which activities aligned with the above-mentioned four domains. Additionally, successful applicants incorporated the following priorities:
- Emphasize quality conversations about values as the core aspect of advance care planning.
- Use meaningful outcome measures for rapid-cycle quality improvement.
- Involve multiple stakeholders and form effective partnerships.
- Involve resources and investments by multiple stakeholders (e.g., health care systems, community organizations, foundations/funders, etc.). (The Foundation will not support the full cost of a project.)
- Employ strong and sustainable business models.
- Utilize a team-based approach.
- Link public engagement to the health care system.
- Integrate with non-medical services (e.g., legal).
Examples of projects considered for funding:
The following are examples of projects and/or project components that were considered for funding. However, this list is not exhaustive and the Foundation encouraged innovative approaches that align with the goals of the funding opportunity.
- Clinical demonstration projects that integrate advance care planning into primary care settings.
- Community-based initiatives to increase public awareness of the importance of advance care planning, including the completion of advance directives and conversations with providers, family members and friends.
- Efforts that design and test innovative, cost-effective reimbursement mechanisms/economic incentives that encourage advance care planning and shared decision-making in order to reduce the utilization of unnecessary medical services and those not consistent with a patient’s goals for care.
- Initiatives that create effective linkages with non-medical professionals, such as elder law attorneys, estate planners and financial planners.
- Projects that take a team-based approach to advance care planning and ensure that all members of the health care team have the education and training required to engage in meaningful conversations with patients and that discussions, decisions and completed forms are appropriately documented in the electronic health record system.
This funding opportunity is focused on smaller-scale projects and the learnings that can be achieved from these efforts to inform future investments in this area. Therefore, the Foundation did not provide funding for the following types of projects or project components:
- Developing a statewide advance directive registry
- Launching a statewide public awareness campaign
- Implementing a clinic-level electronic health record system
- Developing new advance care planning software (although beta testing software as part of a broader, conversation-focused approach would be considered)
Partners/applicants considered for funding (including but not limited to):
- Federally Qualified Health Centers
- Rural Health Clinics
- Community Safety Net Clinics
- Community-based organizations
- Nonprofit long-term care facilities
- Health alliances
- Faith-based organizations
- Local coalitions
- Public agencies
- Colorado Health Foundation Awards Second Cohort of Advance Care Planning Grants
- Colorado Health Foundation Launches $2.75 Million Advance Care Planning Initiative
- Advance Care Planning – Perspectives from Colorado Health Care Providers
- Advance Care Planning: Funding Opportunity Webinar
(Recorded April 26, 2016)
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