FHF Background
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What is the Family Health Foundation?
FHF is a unique action-research partnership combining innovations in health services and social research with the creation of working community-based enterprises in the problem areas under study. Action-research combines rigorous conventional research methods with "social entrepreneurship:" an aggressive pursuit of the creation of new social ventures, new models of community activity and services. Rather than passively observing existing activity or initiatives created by others, FHF will support the creation of pilot projects as needed to test important policy options. We seek to be the pre-eminent social policy laboratory for the changes coming in the 21^st century.

Our goal
The goal of FHF is to improve public health and social policy/programs by applying rigorous research and evaluation protocols to key unresolved questions related to individual and community responsibility. We seek new ways to make families and communities healthier by dealing with the inescapable interdependencies between them. Just as individuals do not achieve greater health or personal success in a vacuum, families live in communities, and communities consist of families. A successful society depends on workable sharing of responsibility and exercise of responsible individual behavior.

How is FHF a "partnership?"
Our preferred mode of operation is to work hand-in-hand with local associations and organizations to create programs and projects which test new methods and seek to answer persistent questions; to bring top-notch local and national research talent to bear on design and evaluation; and to turn over sustainable program operations to local partners at the conclusion of pilot efforts. Unlike most social-science "think tanks," FHF is committed to active engagement in local program development, managing programs directly as needed. Our principals have extensive experience in working directly with communities, and as reflected in our Core Values below, we insist that local partners share in all benefits of programs we initiate.

At the same time, FHF has access, through the University of Texas School of Public Health and related institutions, to world-class policy research resources, worldwide data and state-of-the-art research technology. We have working relationships with other universities, government and private institutions.

FHF’s Core values

Start from the assets
Generative public health and social policy enhances and builds upon the strengths and resources of communities rather than exploiting their deficiencies and deepening their dependency. Conventional policy all too often treats individuals, families or communities as objects or as passive recipients of services, whose shortcomings and dysfunctions are documented in ever greater detail as justification for outside intervention. Communities and adults, like school children, rise to the level of our expectations for/of them. They also possess important resources, whatever their background or circumstances, which can be built upon. Any community, no matter how distressed, has people and indigenous institutions (associations, businesses, nonprofits and informal gatherings) with something to contribute. Recognition and application of these resources are the first steps in involving the community as a partner.

Build on local resources for sustainability
Public responses to social concerns should empower local communities and their institutions to manage long term, sustainable solutions. When tools are developed to change local conditions, they should be in the hands of local people and institutions, from the outset if possible. Programs should be designed for sustainability from the outset as well: dependence of ongoing enterprises on grants and other philanthropy should be avoided. If an ongoing funding source is identified, purchase of services or other transfers should be designed to benefit the payer commensurately, in order that the payer, as a partner with the community, has a continuing stake in success of the enterprise. Enterprises should be adaptable by design, with roles evolving as needed and unafraid to "sunset" at the end of their usefulness if that is most appropriate.

Work within – and with -- context
In addition to the development and operation of social enterprises, research and evaluation on them should be a partnership with communities and existing community institutions, leaving them with improved capabilities at the conclusion of research efforts. FHF strives to avoid conventional "ivory tower" detachment, being a "participant-observer" as far as possible without invalidating findings, and involving local people and organizations in creative ways in the research and evaluation effort. For example, research internships can be valuable in many respects at the high school level as well as the graduate student level. It can benefit a community far more in the long run if a local organization or small business "learns the hard way" to study a program or project than if a highly efficient outside team of experts does all the most challenging work.

Proposing the prototype of a new social contract
Observers from widely diverse perspectives recognize the limits of "welfare state" approaches to health and social problems. As society grows more complex, the economic productivity of society is no longer growing so rapidly that it can compensate for unproductive roles assigned to marginalized people and communities. While traditional charity and "safety net" welfare approaches will be necessary in some form for the foreseeable future, society cannot afford to support the unconstrained growth of such structures and policies or the culture of dependency exacerbated by policies as they have historically operated.

As government is "re-engineered," private institutions and community partners are challenged to develop new roles for themselves as well. Phenomena in the business world like cause-related marketing are breaking down the traditional separation of roles between charity and business. It is worthwhile to revisit the analysis of the ancient Greek-Hebrew philosopher and teacher Maimonides: in private dealings as well as those of government, relationships based on respect, exchange and responsibility are superior to those based on condescension or pity. Interestingly, this analysis is now seen to transcend historical "left and right" ideologies: terms like empowerment are a part of the conclusions reached by policy theorists of diametrically opposed viewpoints. For example, the "communitarian" analysis posits a strong element of personal responsibility as concomitant with civil and societal rights.

Therefore, FHF proposes a new vision of sustainable partnerships which build upon community assets, consistent with the Core Values outlined above. We suggest that much of our work will consist of the creative analysis of persistent policy dilemmas or questions in the light of this vision. The "Community Health Worker" project proposal illustrates how these principles could be applied.

Although FHF was only incorporated in the Fall of 1996, we have already undertaken some important new initiatives:

Community Resource Advisors

This groundbreaking project is FHF’s maiden effort in the community-institutional partnership mode described above. We are working toward a full-scale demonstration of a neighborhood-based peer health outreach program which will employ former welfare recipients and other residents of low-income communities as peer advisors in the use of Medicaid managed care. The CRA will partner with families to foster better understanding of the health care system and increased use of preventive care. This model is based on proven successful models of home visitation and peer education. In early stages of program development FHF is already working collaboratively with the largest Medicaid provider in the State of Texas, as well as with the regional office of the State Health Department. Once demonstrated, this model should be sustainable as a capitated service contract under Medicaid, and should be widely applicable in other states and in other populations, e.g., Medicare. This demonstration program will also stimulate collateral program development and job creation and local transportation sectors.

International exchange
The tradition of community responsibility and the mobilization of community assets is a significant feature of the Chinese health education system. FHF has already hosted a visiting Study Tour of professionals from the Ministry of Health of the People’s Republic of China, coordinating program activities in five major U.S. universities. This tour was examining educational and training methods in public health. Discussions are underway with representatives of one of China’s provincial governments to arrange individual study in the U.S. for public health leaders from the province.

Health manpower planning
FHF has administered a contract as part of a university consortium helping the Colombian Ministry of Health conduct long range planning for health personnel requirements.

Family health education and prevention
FHF has managed an evaluation contract for "Project Success," a CSAP-funded demonstration of parenting education for teens as a long-term prevention strategy for substance abuse and family violence.  We are included in a pending proposal to demonstrate peer education methods in asthma self-management, in partnership with a local Medicaid/SCHIP MCO, a medical school and a community-based clinic.

OTHER RESOURCES AVAILABLE TO FHF
FHF has direct access to public health and medical education faculty resources and crucial health data sources through the University of Texas system.

HOW CORE SUPPORT FUNDS WILL BE USED
Core support for FHF will be invested in infrastructure development and new program exploration: data systems and linkages, basic research to open new markets for the research already undertaken, and reporting and publishing findings. New program opportunities require good background research before fundable project proposal can be developed. While these activities can be accomplished by "borrowing" staff time and other resources from funded projects, this dilutes such activities and artificially inflates project costs.