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A Qualitative Evaluation of Advances in Emergency Department Opioid Use Disorder Care in Michigan

January 10, 2023

The United States opioid epidemic claims the lives of tens of thousands of Americans each year due to opioid overdose. Hospital emergency departments (EDs) have been essential in combatting the crisis by stabilizing patients who are experiencing an overdose and other symptoms of their opioid use disorders (OUD). Over time, EDs have also become more involved in providing other addiction treatment services, such as prescribing and administering medications for opioid use disorder (MOUD) and referring their patients to outpatient behavioral health care providers for follow-up treatment. Policymakers have been essential in driving EDs to expand the scope of their addiction medicine services and referrals by creating specialized programs that provide incentivizes to participating hospitals.The following report summarizes advances in opioid use disorder care within EDs in 19 hospitals across 8 health systems in Michigan. These hospitals participated in an initiative created by the Community Foundation for Southeast Michigan (CFSEM) in collaboration with the Michigan Opioid Partnership (MOP), a public-private collaborative with a mission to reduce opioid overdoses in Michigan by improving the access and quality of prevention, treatment, harm reduction, and recovery services. The initiative was supported by State Opioid Response grants from the Michigan Department of Health and Human Services. Vital Strategies, a global public health organization that helps governments strengthen public health, provided support, technical assistance, and resources to improve hospital coordination and designed the evaluation. Specifically, hospitals were provided funding by CFSEM to improve OUD care training, coordination, delivery, and quality in their EDs. Hospitals and health systems funded by CFSEM included the University of Michigan Health System (Michigan Medicine hospital), Trinity Health (Mercy Health Muskegon, Mercy Health St. Mary, St. Joseph Mercy - Ann Arbor, St. Joseph Mercy Chelsea, St. Joseph Mercy Livingston, St. Joseph Mercy Oakland), Henry Ford Health Systems (Henry Ford – Main, Henry Ford - Wynadotte/ Brownstown), Beaumont Health Systems (Beaumont - Royal Oak, Beaumont – Troy, Beaumont – Wayne), Ascension (Ascension St. John Hospital, Ascension Genesys Hospital), Munson Healthcare (Munson Medical Center - Traverse City, Sparrow Health System (Sparrow Hospital - Lansing), Spectrum Health (Spectrum Health Butterworth), War Memorial, and Hurley Medical Center. After receiving funding, hospitals created work plans related to improving opioid use disorder care in their EDs, including by increasing their number of employed X-waivered providers, integrating clinical tracking and support tools into electronic medical records, and connecting patients with behavioral health care providers in the community to establish treatment continuity (i.e., "warm handoffs"). Researchers with the Bloomberg Overdose Prevention Initiative at the Johns Hopkins Bloomberg School of Public Health evaluated hospital improvement in these areas using surveys and qualitative interviews with participants.

Evaluation of the Baltimore Health Corps Pilot: An Economic and Public Health Response to the Coronavirus

September 30, 2022

The Baltimore Health Corps was a city-run pilot launched in June 2020 and concluding in December, 2021. The pilot simultaneously addressed two issues: the spread of COVID-19 and the resulting employment crisis faced by Baltimore residents.The Baltimore City Health Department and the Mayor's Office of Employment Development led the Baltimore Health Corps, drawing on their experiences with equitable recruitment and hiring practices, workforce-supporting activities and public health worker training. Together, they led a team of public and private partners that included the Baltimore Civic Fund, Baltimore Corps, HealthCare Access Maryland (HCAM), Jhpiego and the Mayor's Office of Performance and Innovation.The initiative tracked those who contracted the virus at the height of the pandemic and connected COVID-19-positive individuals with testing, resources and other assistance. In doing so, the Baltimore Health Corps also placed unemployed workers on a path to high-quality, lasting careers via temporary positions as community health workers with the Baltimore City Health Department and HealthCare Access Maryland (HCAM). The program hired from a pool of Baltimore residents who reflected the city's racial and ethnic demographics and were unemployed, underemployed or furloughed because of the pandemic. By September 2021, 336 health workers had received training and took on roles within either the Health Corps' contact tracing and outreach program or the care coordination and access program.While these health worker positions were intended to last just eight months, as the pandemic persisted, the jobs were extended thanks to funding from the American Rescue Plan Act. As of May 2022, 126 Baltimore Health Corps workers remain employed with either the health department or HCAM, while 119 former staff members have since moved on to other employment opportunities.This is the Final Report to follow the Early Lessons Report for the Baltimore Health Corps Pilot Study. Readers are encouraged to review the Early Lessons Report for a detailed description of the formation of the Pilot Study, the role of each partner, as well as findings from the first year of the Pilot Study.

The State of Global Air Quality Funding 2022

September 20, 2022

The only global snapshot of clean air funding from donor governments and philanthropic foundations. This report highlights funding trends and gaps in 2015-2021, as well as recommendations for smarter investment for people and planet.99% of the world's population breathes air that exceeds World Health Organization air quality guidelines. Cleaning the air is a massive opportunity to improve public health and climate change. Because air pollution and climate change are mainly caused by burning fossil fuels, these problems can be tackled together. By addressing these issues in isolation, funders and policymakers drastically overlook the potential of clean air to realise multiple health, social and sustainable economic benefits.Our fourth annual report is the only global snapshot of projects funded by international development funders and philanthropic foundations to tackle air pollution. We identify gaps in funding, and opportunities for strategic investment and collaboration for systemic change. As the world prepares for COP27 in Egypt, we call for more joined up policies and funding to address air pollution, climate change and unsustainable economic growth simultaneously. This report provides recommendations for decision makers, policy makers and philanthropic foundations.

Tackling the Dual Economic and Public Health Crises Caused by Covid-19 in Baltimore: Early Lessons from the Baltimore Health Corps Pilot

April 13, 2022

On March 12, 2020, the first case of Covid-19 was diagnosed in Baltimore City. Its infection rate increased rapidly through March and into April and May, proving to be 4 times higher among Latino residents and 1.5 times higher among Black residents than the city's White population. At the same time, the city's unemployment rate surged from 4.9 percent in March to a peak of 11.6 percent in April 2020. In June, The Rockefeller Foundation supported the Baltimore City government in launching the Baltimore Health Corps (BHC), a pilot program to recruit, train, and employ 275 new community health workers who were unemployed, furloughed, or underemployed, living in neighborhoods hardest hit by the health crisis and especially those residents unemployed as a result of Covid-19. BHC used equitable recruitment and hiring practices to employ contact tracers, care coordinators, and support staff, with a focus on good jobs, fair pay, training, skill-building, and support to improve career trajectories. This report, compiling data and interviews midway through the project, is a look at some of the early successes and the challenges ahead.

Parents 2021: Going Beyond the Headlines

December 8, 2021

Learning Heroes, in partnership with National PTA, National Urban League, UnidosUS, and Univision, released Parents 2021, our annual nationwide research conducted with K-12 parents, teachers, and, for the first time, principals. This timely research examines the commonalities and differences between mindsets of parents, teachers, and school leaders, and looks at their perceptions of family engagement.

Using harmonized historical catch data to infer the expansion of global tuna fisheries

September 13, 2019

Despite worldwide demand for tuna products and considerable conservation interest by civil society, no single global dataset exists capturing the spatial extent of all catches from fisheries for large pelagic species across all ocean basins. Efforts to spatially quantify the historical catch of global tuna fisheries have been restricted to the few taxa of major economic interest, creating a truncated view of the true extent of the fisheries for tuna and other large pelagic fishes. Individual Regional Fisheries Management Organizations (RFMOs) have given varying degrees of attention to minor taxa and non-target species only in more recent years. Here, we compiled and harmonized public datasets of nominal landed catches, as well as spatial data on reported catches of large pelagic taxa reported for the industrial tuna and large pelagic fisheries by tuna RFMOs for the last 60+ years. Furthermore, we provide a preliminary estimate of marine finfishes discarded by these fisheries. We spatialized these data to create a publicly available, comprehensive dataset presenting the historical reported landed catches plus preliminary discards of these species in space for 1950–2016. Our findings suggest that current public reporting efforts are insufficient to fully and transparently document the global historical extent of fisheries for tuna and other large pelagic fishes. Further harmonization of our findings with data from small-scale tuna fisheries could contribute to a fuller picture of global tuna and large pelagic fisheries.

Stemming the Tide of Coastal Overfishing: Fish Forever Program Results 2012–2017

July 1, 2018

Fish Forever is the first global solution that brings together 30-plus years of Rare's experience in community empowerment, social marketing and behavior adoption with the technical, policy and financial skills needed to secure lasting results for people and nature.This report describes the results of 41 Fish Forever sites, representing over 250 communities across Brazil, Indonesia and the Philippines. It is the first opportunity to analyze the past five years of design (2012–14) and implementation (2014–17). Using a comprehensive monitoring and evaluation protocol, the report synthesizes information from three country learning reports, 2,400 in-water surveys of coral reefs, 15,000 individual and household surveys, and the landing records from nearly 56,000 fishing trips — and represents the work of 70 Rare staff and 80 partner organizations who have committed the time of more than 557 global staff to this project.Ecological and social responses to three years of program implementation are promising, and importantly, results from the data infer that Fish Forever is working:* Ecologically, fish are recovering — fish biomass is increasing, both inside and outside no-take reserves;* Socially, communities are empowered — social resilience, pride and livelihoods are improving;* 51 legal and functional management bodies were established across the 41 sites;* 63 managed access areas were built or strengthened, encompassing nearly 600,000 hectares of coastal waters with 27,000 hectares secured in fully protected reserves; and* Strengthened policies and governance provide a clear path to scale.The initial implementation period has been an enormously valuable learning experience for Rare and our partners. This report is an opportunity to reflect on Fish Forever's impact and consider our work in the coming years.

Funding Socioeconomic Diversity at High Performing Colleges and Universities

February 15, 2017

With finite budgets and multiple priorities, institutions limit the funds they allocate to need-based aid and other programs that support low- and moderate-income students. Yet even with those constraints, some top-performing colleges and universities have enhanced their commitment to serving low- and moderate-income students, and have found the financial means to do so. This paper profiles five such institutions: Franklin & Marshall College, University of California, Berkeley, University of Richmond, University of Texas at Austin, and Vassar College. The paper reviews increases in aid, support, and opportunity at these schools, and highlights strategies that each has pursued to reallocate funds in ways that are financially sustainable, maximally effective, and broadly supported by institutional stakeholders.

Encouraging Evidence on a Sector-Focused Advancement Strategy: Two-Year Impacts from the WorkAdvance Demonstration

June 28, 2016

This report summarizes the two-year findings of a rigorous random assignment evaluation of the WorkAdvance model, a sectoral training and advancement initiative. Launched in 2011, WorkAd-vance goes beyond the previous generation of employment programs by introducing demand-driven skills training and a focus on jobs that have career pathways. The model is heavily influenced by the positive findings from the Sectoral Employment Impact Study (SEIS) completed in 2010. A major component of the WorkAdvance model, in common with the programs studied in the SEIS, is formal training offering industry-recognized certifications, reflecting the hypothesis that skills acquisition is necessary for advancement. The model also requires providers to be far more employer-facing than traditional training programs, taking into account multiple employers' changing skill requirements, employee assessment practices, and personnel needs. This report presents the imple-mentation, cost, participation, and two-year economic impacts of WorkAdvance. The economic results are based on unemployment insurance earnings records and a second-year follow-up survey.The WorkAdvance program operations and evaluation are funded through the federal Social Innovation Fund (SIF), a public-private partnership administered by the Corporation for National and Community Service. This SIF project is led by the Mayor's Fund to Advance New York City and the NYC Center for Economic Opportunity in collaboration with MDRC.Key Findings*All providers translated the WorkAdvance model into a set of concrete services, but it took time— more than a year for some components and providers -- and a substantial amount of tech-nical assistance and support. As a result, at some sites, later study enrollees were more likely than earlier ones to experience a fully implemented and "mature" WorkAdvance program.*Overall, WorkAdvance resulted in very large increases in participation in every category of services, as well as in training completion and credential acquisition, compared with what would have happened in the absence of the program. Expenditures for the operation of WorkAdvance fell between $5,200 and $6,700 per participant at the four providers delivering the program.*WorkAdvance providers increased earnings, with variation in results that closely matched the providers' experience in running sector-based programs and the extent to which the services they offered were demand driven. The most experienced sectoral provider, Per Scholas, had large and consistent impacts on both primary and secondary outcomes. Madison Strategies Group and Towards Employment, providers new to sectoral training, had promising but less consistent results that grew stronger for later enrollees. One provider, St. Nicks Alliance, did not produce positive impacts. The results did not differ dramatically across subgroups, though en-couragingly, WorkAdvance was able to increase earnings among the long-term unemployed.The evaluation as a whole provides important information for workforce development providers interested in pursuing a sector strategy. The analysis considers the role played by providers' sector-specific training and preparation and the role played by the nature of the sectors themselves. Future priorities that emerge from the results are (1) understanding how to help the more disadvantaged access the programs and (2) learning how to build service capacity, given how complex the model is to run.

Coral Reef Alliance: 2015 Annual Report

May 1, 2016

Over the past year, we have accomplished a great deal in our efforts to save coral reefs and we are excited to share these successes in our 2015 Annual Report. We also want to share our vision for the future of coral reefs and how this inspires our ongoing work. Many of the benefits from our reefs depend on living corals. Corals are the architects of the reef, and build the structures that provide nurseries and shelter for millions of sea animals. They provide people with livelihoods from fisheries and tourism, storm protection and sources for new medicines. These benefits are at risk as coral reefs decline around the world, but together, we can save them. Corals are struggling due to local pressures and global climate change; however, we have identified a solution that will help corals build reefs and maintain the needed benefits for people and wildlife. The answer is in the corals themselves. Corals are incredibly diverse, with many species and varieties spread across the reefs. Corals haveadapted for hundreds of millions of years, and if allowed, will continue to do so. For example, some corals can live in warmer water; others can thrive in polluted oceans. Special corals like these, and their offspring, may be best suited for the reefs of the future. Our aim is to ensure that enough of these corals survive on enough healthy coral reefs so they can repopulate other nearby reef sites. In this way, corals—and everything that depends on them—will have an opportunity to adapt to a changing environment.

Executive Summary for Investing for Sustainable Global Fisheries

January 15, 2016

This publication is an Executive Summary of Investing for Sustainable Global Fisheries. This summary provides a brief overview of the work that was undertaken, a description of each Investment Blueprint, and some of the critical findings from the work. At the heart of each Investment Blueprint lies a proposed set of fishery management improvements and profitable investments that seek to have positive ecological and social impacts. On the ecological side, the goals are to maintain or restore fish stocks, reduce bycatch of nontarget species, and protect and restore marine habitat. On the social side, the goals are to improve fisher livelihoods, empower local communities, and contribute to local and regional food security.

Investing for Sustainable Global Fisheries

January 12, 2016

To better channel the flow of capital to the sustainable fisheries need and opportunity, Bloomberg Philanthropies and The Rockefeller Foundation supported Encourage Capital to develop six Investment Blueprints, each intended to serve as a roadmap for the growing number of investors, entrepreneurs, and fishery stakeholders seeking to attract and deploy private capital both to scale and to accelerate fisheries reform. The Investment Blueprints profile hypothetical investment strategies for application to three types of fisheries, including small-scale fisheries, focused on improving management of moderately distressed near-shore fish stocks landed by community-based, artisanal fishers using small vessels; industrial-scale fisheries, focused on improving management of severely distressed fish stocks landed by both artisanal and industrial fishers using a wide range of vessels and gear types; and national-scale fisheries, focused on implementing specific national-scale management improvements. The Investment Blueprints present investment strategies based on prototype fisheries spanning three countries and more than 25 species. By analyzing specific fisheries' current productivity, ecology, potential long-term yield, management regime, and supply-chain dynamics, Encourage was able to design and structure investment strategies that incorporate real-world risks and return potential. The Investment Blueprints offer viable models that can be replicated across a wide array of fisheries and geographies, mobilizing private capital to protect and restore the oceans' bounty.