John A. Hartford Foundation
The John A. Hartford Foundation (JAHF or the Hartford Foundation) is a private United States-based philanthropy whose current mission is to improve the care of older adults. For many years, it made grants for research and education in geriatric medicine, nursing and social work. It now focuses on three priority areas: creating age-friendly health systems, supporting family caregivers and improving serious illness, and end-of-life care. History. Based in New York City, the foundation was founded in 1929 by John Augustine Hartford and later joined by his brother George Ludlum Hartford, the family  owners of the A&P grocery chain. The foundation's mission from the beginning has been "to do the greatest good for the greatest number." In the early and mid-20th century, the foundation primarily made grants for research centered on basic and clinical medicine and health care quality and costs. It was at one time the largest funder in these areas. In 1982, the focus turned towards improving the care of older adults, as there became an increasing need to fund this underserved area. In 1994, the foundation made this priority its chief mission. Leadership. Terry Fulmer, PhD, RN, FAAN, is  the President of the foundation. She serves as the chief strategist for the foundation, and her vision for better care of older adults is influencing the Age-Friendly Health Systems social movement. Activities. Aging and health. From about 1980 to 2012, the foundation focused on a two-pronged effort to build training capacity and conduct research into different models of care for older adults at schools of medicine, nursing, and social work. Its current programs aim to more directly impact the health of older adults. In 2013, the Foundation organized its grantmaking in five portfolios: Interprofessional Leadership in Action, Linking  Education and Practice, Developing and Disseminating Models of Care, Tools and Measures for Quality Care, and Policy and Communications. In 2015 and 2016, the foundation implemented its current priority areas: creating age-friendly health systems, supporting family caregivers, and improving serious illness and end-of-life care. In 2016, the Age-Friendly Health System initiative was started in collaboration with the Institute for Healthcare Improvement (IHI), American Hospital Association (AHA), and the Catholic Health Association of the United States (CHA). In 2008, the foundation led a consortium of grantmakers to fund a study from the Institute of Medicine to look  at the "crisis" of an ill-prepared workforce and outdated models of caring for older adults." Medicine. One of the largest and most important programs in the foundation's recent history has been to help build academic capacity in geriatric medicine through the Centers of Excellence in Geriatric Medicine, which started in 1986. They are located at academic medical centers around the country, and are known as high-throughput producers of academic geriatricians as well as the generators of basic, clinical, and population level medical knowledge about older adults. As many as 55,000 physicians are trained or mentored at these  centers annually. The foundation has also supported training and development programs for medical students, fellows, junior faculty, and senior thought leaders through its funding of the Association of American Medical Colleges for geriatric scholarships, residence programs, and curriculum development. Another important initiative has been building bridges from geriatric medicine out to the subspecialties of internal medicine and surgical and related specialties. Nursing programs. The foundation's strategy to improve nursing care for older adults was also largely based on creating Centers of Excellence, and has been credited with providing extraordinary leadership in directing attention to the special nursing needs of  older adults. Social work. Initially the foundation focused on enhancing the capability of schools of social work to train aging-competent social workers. It has increasingly focused on providing training and practice opportunities in real-world settings. Integrating and improving services. The foundation has long had an interest in helping to improve the delivery of health care in the U.S. In the 1970s, under the direction of CEO Bob Higgins, the foundation played a key role as a convener of stakeholders to discuss cost containment in healthcare. "We would go into a community and get key people together. In Des  Moines we got together the Des Moines Register, a union, and some local businesspeople and we conducted a study about what was going on in healthcare. In Utah it was the Mormon Church [sic], a key senator, and the governor who all came together. We would go into these communities and bring all these people together and get them to look at the healthcare situation. Only foundation money could bring these people together. Inevitably, these activities led to an initiative of some kind and, often, the creation of an HMO." Leadership and policy. JAHF has avidly supported thought leaders in  policy, from funding National Health Policy Forum seminars to investing in various reports by the National Academies. The foundation continues to engage in the policy sphere through its various partnerships with government agencies. Special grants. The foundation has made rare special grants, including grants in response to the 911 terrorist events, and Hurricanes Katrina and Rita. The grants have often focused on better disaster preparation and relief policies for institutionalized older adults. Grantee communication. Beginning in 2006, the foundation has made efforts to communicate with its grantees and other stakeholders, sponsoring grantee perception surveys by the Center for Effective Philanthropy  and released in part to the public. (A 2010 Grantee Perception Report is not currently publicly available.) It has circulated an e-newsletter to its stakeholder community since at least 2004, and has launched an online blog, Health AGEnda. Governance. The foundation, like most large U.S. charitable foundations, has no set closure date. Although not directly related by mission or program activities, in 1983 the Hartford Family Foundation was established in the State of New Jersey to preserve "the memory of the late George Huntington Hartford and the company he founded in 1859." Investments. The foundation solicits no new donations , and invests the assets that it has not yet distributed to maximize the return on investment. Unsolicited donations or estate gifts are deposited into the foundation's core accounts, while larger donations are earmarked and targeted for projects mutually agreeable to the foundation and the donor(s). Awards and honors. The foundation's grantees are often recognized with prestigious awards and honors—including multiple MacArthur Fellow ("genius") grants The foundation itself has won recognition; for example, in 2011 the foundation received the Community College of Philadelphia's Foundation Keystone Award for its work on the needs of older adults in community  college nursing programs. Criticism. The foundation's genesis as an offspring of the A&P supermarket fortune, and its consequent stockholding ties with the A&P during the chain's marketplace decline in the 1960s and '70s, proved almost disastrous to the solvency of the foundation. At several points grantmaking was placed on hiatus. In 1969 the foundation attracted attention of the U.S. House Ways and Means Committee during hearings about the tax treatment of foundations with substantial financial links to corporations. Huntington Hartford, John and George Hartford's nephew and never a part of the foundation's governance structure, was highly  critical of this lingering financial relationship. A period of A&P stock divestiture ensued and the foundation returned to financial stability by the late 1970s.