Q&A on Trinity Health Grant to Trenton Health Team

What are the specifics of the grant to Trenton Health Team? How much money is provided each year of the grant? Are there likely extensions beyond the 5-year commitment?

Trenton, through the Trenton Health Team (THT), was selected as one of the six inaugural Transforming Communities Initiative (TCI) funded communities. Trinity Health has committed $500,000 per year to Trenton, through a combination of cash and technical assistance to THT and its partners. TCI was developed as a key strategy of Trinity Health’s People-Centered 2020 Community Health and Well-Being strategy. Trinity Health sees partnership, collaboration and community engagement as important steps in addressing policy, system and environmental changes that influence social determinants and health outcomes. Required, pre-selected interventions are:

• Tobacco 21- http://tobacco21.org/
• Complete Streets – http://www.smartgrowthamerica.org/complete-streets
• Implementation of Nutrition Standards in Early Childhood Settings (Daycare and Head Start)
• Breastfeeding Policy Enhancement
• School Board Policy to Enhance Physical Activity in Schools
• Food and Beverage Standards/Competitive Foods Policies

Designated partners who will provide programmatic technical assistance are Georgia Health Policy Center, ChangeLab Solutions, and The Public Goods Project. The Reinvestment Fund and IFF, two Community Development Financial Institutions, will serve as capital partners, and will provide the loan capital and related technical assistance to ensure implementation of capital projects that address gaps in the built environment.

The Trinity Health release talks about investments of about $80 million in grants, loans, community match dollars and services for the six communities receiving grants in this program. How will that money be allocated? When?

Trinity Health has not yet released more specifics about this aspect of the program. We anticipate additional information to be released as the program roll-out continues.

It seems clear that THT was selected because of its track record in collaborative efforts to make the city a healthier place to live. What specifically have you done that qualified you for this selection?

Trenton was a strong contender for this opportunity because of the many collaborative efforts already under way in Trenton. Given our history, THT is well-positioned to accomplish project goals, building on our connections into the broader community. By virtue of our collaborative structure, we are naturally connected to the healthcare system and to external stakeholders who have a vested interest in the success of the THT mission—to improve the health of Trenton. Both the Board of Directors and Community Advisory Board of THT draw on leading health and social service agencies, as well as educational and faith-based organizations for their membership. With all the hospitals, the only Federally Qualified Health Center, and the City of Trenton’s Department of Health and Human Services represented on our Executive Committee, and with established committees and a Community Advisory Board that meet regularly to discuss issues, needs, and strategies, there are mechanisms for ongoing communication in place and a strong collective will to bring about much-needed change for the community. Another strong advantage for our efforts is the fact that the City of Trenton is a strategic partner, with the Director of Health and Human Services serving simultaneously on the Executive Committee of THT and as a member of the Mayor’s Cabinet. In addition, the CHNA and CHIP process have created a strong foundation and natural vehicle for continuation of our collaborative, community-based approach wherein we engage organization leaders, community residents, corporate partners and funders to help define and advance our initiatives and programs. This effort also dovetails with the City of Trenton Master Plan (Trenton250), which has a strong health component, and which has been supported by THT’s Community Advisory Board.

What has THT done to increase access to healthy food with stores and farmers markets?

THT participates actively in the Trenton Healthy Food and Fitness Network (THFFN), a collective impact coalition that grew out of the NJ Partnership for Healthy Kids-Trenton, which is operated through the Trenton YMCA and the Statewide YMCA Alliance. This coalition has been responsible for establishing four healthy corner stores and has conducted surveys and laid the groundwork for adding more. In addition, the Greenwood Ave. Farmers Market was launched in 2015 through the efforts of this group. The market is open weekly on Monday afternoons, June through October, offering fresh, locally grown produce to area residents, accepting WIC, SNAP, and other payment options to ensure affordability. The market also features health screenings and referral services coordinated by THT plus nutrition counseling through Henry J. Austin Health Center and healthy cooking demonstrations by Rutgers Cooperative Extension.

What has THT done to build new playgrounds? To expand school breakfast programs? To create school gardens?

These efforts have also been led by our partners at NJPK-T and Isles, Inc., both of which are active in the THT Community Advisory Board, providing leadership in the Obesity & Healthy Lifestyles working group. Among the NJPHK-T achievements have been the adoption of a District Wellness Policy, expansion of the school breakfast program across the city schools, and the building of several new playgrounds, constructed with parent and community volunteers. Isles currently supports more than 30 gardens that they have helped to launch at schools across the district. In addition to building school gardens, Isles has worked with THT to build and expand gardens at Trenton churches through the Faith in Prevention program.

Are the partners mentioned in the Trinity Health release your only partners? If not, who are your other partners, and why were those specific partners mentioned?

The partners mentioned in the release were selected because they provide services in one or more or the pre-selected focus areas of this grant. The list is not exhaustive. THT partners with more than 50 organizations throughout the community, and additional partners will be brought in as the community action plan is developed and refined.

Will you share the grant funds with these partners?

Some grant funds will be sub-granted to partners who provide direct services in support of the initiative. The specifics of those awards will be determined through the community action plan, which will be developed over the next few months.

Did your proposal articulate specific ways to make the city healthier?

Trinity Health has pre-selected certain interventions with demonstrated effectiveness to address some of the largest drivers of population health across communities. We will be working to implement those strategies, along with others that we will choose based on Trenton-specific health needs and priorities.

You previously conducted a CHNA and then created a CHIP for Trenton, in collaboration with many other Trenton, Mercer County and state nonprofits and governmental organizations. Have you implemented the CHIP?

We have been working diligently with our partners to implement the CHIP, which was envisioned as a three-year plan. We also just updated the CHNA (available at www.trentonhealthteam.org/resources/documents-and-reports/), which has reaffirmed many of the previous CHNA findings and identified some new concerns. This report will continue to guide our CHIP implementation.

How will you leverage that previous work in carrying out this grant?

Our CHNA and CHIP priorities align with the strategies that are part of this initiative. The grant will allow us to build on work we are already doing and will provide additional resources to expand and enhance those efforts. It will also enable us to add projects that had been identified as valuable for our community, but for which we did not have funding or personnel to move forward.

The release says all grant programs will focus on policy, systems and environmental changes that can directly impact specifically identified areas of high local need and reduce tobacco use and obesity. What are the areas of high local need that you identified with your CHNA? Will those be the areas you target to address in this grant?

The needs we identified in the CHNA were: 1) Health Literacy and Disparities, 2) Safety & Crime, 3) Obesity & Health Lifestyles, 4) Substance Abuse & Behavioral Health, and 5) Chronic Disease: Diabetes, Hypertension, and Cancer. The focus areas for the Trinity Health grant include policy, systems, and environment changes aimed at creating a climate that will help to mitigate all of these community health challenges.

What is the relationship between St. Francis Medical Center, a Trinity hospital, and THT? What are you already doing with this hospital?

St. Francis Medical Center is one of the founding members of THT and has been integrally involved in developing the vision, mission, and strategies for all of THT’s work. St. Francis has representatives on THT’s Executive Committee, Board of Directors, as well as the THT-ACO Board. St. Francis co-led the 2013 CHNA with THT, is a data partner in the Trenton Health Information Exchange (HIE), and is active in the THT Community Advisory Board and its work groups. Specific areas of collaboration include care coordination, programming through Faith in Prevention, and participation in developing a Clinical Decision Support system.

How is the City of Trenton involved with this grant? With THT in general?

As with St. Francis, the City was a founding partner of THT, with full representation in its governance and committee structure. Having the City’s health department involved directly with the private healthcare system is one of THT’s uniquely innovative features. The City provides office space for THT personnel and works closely in implementation of all THT’s community-based programming such as the “Inroads for Health” project, funded by Janssen Pharmaceuticals. Conversely, the Obesity & Healthy Lifestyles work group of THT’s Community Advisory Board has supported the City’s planning efforts as part of a grant received by Rutgers University to develop a Health Systems Element for the Trenton250 Master Plan.

The release mentions local matching dollars. Is there such a match for this grant to THT?

Yes. A minimum of 25% is required for the first year, with higher levels in subsequent years. THT has already secured requisite matching funds for year one, but will be working to leverage this grant to secure additional resources for the initiative going forward.

Will you collaborate with other grant recipients? How will that benefit the residents of Trenton?

As part of this grant program, Trinity Health will be facilitating a learning community comprised of representatives from all six of the awarded communities. This will include in-person as well virtual interactions to share successes and challenges in implementing the program.

Please cite some ways THT has made a difference in the lives of people in general in Trenton. How about individuals, particularly in the areas of “high local need?”

THT conducts health screenings and provides basic information at venues throughout the city, including health fairs and the new Greenwood Ave. Farmers Market. THT has helped navigate care for close to 200 clients who are among the highest utilizing, high-cost patients in the healthcare system. In helping them to address their healthcare needs, THT has taught them how to advocate and care for themselves, empowering them to have a more positive experience in the system, with improved health outcomes. THT is also educating individuals about chronic disease self-management and better nutrition and active lifestyle choices for themselves and their families through grants from the NJ Department of Health.

What is the governance structure of THT?

THT is governed by a 15-member Board of Directors and relies heavily on guidance from our Community Advisory Board (a standing Board sub-committee) to set the strategic direction for all our Community Partnership programs, including the Transforming Communities Initiative. More information and a list of THT’s current Board members can be found at www.trentonhealthteam.org/about-us/

How many employees do you have?

THT currently has 12 full-time employees, and this grant will fund a new full-time Project Director position that will join THT in the next few months.

How is THT funded? Do you receive federal or state grants? What are some notable grants from private sources?

THT receives gifts and grants from foundations, corporations, government agencies, and individuals. THT also receives payment for contracted services such as care coordination and data management through the Trenton HIE. Among our most significant private funders is The Nicholson Foundation. Major institutional funders are shown at www.trentonhealthteam.org/about-us/our-partners/

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