In the News | Month: May 2016

Grantee News: West Health Institute launches exciting research study with Meals on Wheels and Brown University

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Two-year study to take place in six cities around the country to identify extended benefits of Meals on Wheels service to vulnerable seniors

SAN DIEGO, CA; ARLINGTON, VA and PROVIDENCE, RI – May 25, 2016 – The Gary and Mary West Health Institute, Meals on Wheels America and a research group in the Brown University Center for Gerontology and Healthcare Research are collaborating on a two-year research program to investigate opportunities to improve the general health and well-being of homebound seniors by integrating health and safety screenings into daily meal delivery services. The research will be taking place in the following cities:

  • Cambridge, OH – Guernsey County Senior Citizens Center
  • Fort Worth, TX – Meals on Wheels of Tarrant County
  • Raleigh, NC – Meals on Wheels of Wake County
  • San Diego, CA – Meals on Wheels of Greater San Diego, Inc.
  • Sheboygan, WI – Fresh Meals of Sheboygan County
  • Westwood, NJ – Pascack Valley Meals on Wheels

Meals on Wheels volunteers visit with senior clients daily and are often the only person a senior will see in a day. With 9.6 million seniors facing the threat of hunger, and 15.2 million living alone in isolation, the Meals on Wheels staff and volunteers build important relationships with meal recipients and are usually the first person to observe health status changes that could lead to more serious issues, and to routinely report any issues to caregivers or healthcare providers.

The aim of this two-year program, called More Than a Meal Phase 3, is to standardize reporting mechanisms and improve communication with healthcare providers to prevent an adverse health event. The assessment will help identify health, safety and social needs such as loneliness, depression or fall risk. By providing volunteers with simple screening tools and user-friendly technology, the study is designed to improve care coordination across the medical and home community, informing providers and caregivers of changing conditions before a potentially catastrophic health event occurs.

“Our More Than a Meal research series with Brown University continues to reinforce the holistic value of Meals on Wheels,” said Ellie Hollander, President and CEO of Meals on Wheels America. “It is our hope that Phase 3 will enable us to rigorously understand and continue to validate the extended benefits of crossing the threshold into a client’s home on their overall health and quality of life.”

“Meal delivery is an essential support for homebound seniors, providing a vital lifeline to the outside world for these individuals and we believe the Meals on Wheels staff and volunteers can also be a critical link into the healthcare system, bringing to light possible health, wellness and safety needs,” said Shelley Lyford, president and CEO of the West Health Institute and Gary and Mary West Foundation. “By researching how we can coordinate and extend the ability of the drivers to monitor the health and well-being of clients, we hope to identify new ways to improve the lives of seniors through the people that may be one of their only connections to the outside world.”

Meals on Wheels America has been an important collaborator with the West Health Institute and Gary and Mary West Foundation, which in February announced a $200,000 grant to conduct a retrospective review of the demographic and associated healthcare information of Meals on Wheels recipients to gain insight on the program’s health benefits to Medicare recipients as part of the More Than a Meal Phase 2 study. The Foundation has also supported Meals on Wheels of Greater San Diego to build a state-of-the-art meal center with a commercial kitchen that served more than 430,000 meals to 3,000 seniors in 2015.

“This program provides an opportunity to further analyze the impact that home-delivered meals can have on the health and well-being of older adults,” said gerontologist Kali Thomas, assistant professor (research) of Health Services, Policy and Practice in the Brown University School of Public Health. “In the data we have gathered in earlier phases we have found important benefits of home-delivered meals beyond just nutrition. As we continue this research, it is important to have the support of organizations like the West Health Institute and Gary and Mary West Foundation that understand the significance of the connection between Meals on Wheels programs and the people they serve.”

California State University Institute for Palliative Care Issues Call for Research Proposals: June 1 – August 31

Seed Grant Funding from the Gary and Mary West Foundation will Support Academic Faculty Education and Research

SAN DIEGO, CA – May 24, 2016 – The California State University Institute for Palliative Care (Institute) has received support from the Gary and Mary West Foundation to award seed grant funding worth $10,000 to academic faculty attending the Engaging the Next Generation: Academic Palliative Care Education and Research Symposium.  The event, which will be held from September 30 – October 1, 2016 on the campus of California State University San Marcos, is designed to advance education and research in palliative care among academic faculty.  Applications for grants will be accepted from June 1 – August 31, 2016, with application information provided at registration. The grants to be awarded will be announced at the symposium.

Attendees of the symposium are encouraged to submit proposals for seed grant funding to demonstrate the potential of innovative educational and research projects that improve care and enhance quality of life for serious and chronically ill patients. The symposium will bring together faculty from across the U.S. who teach and conduct research in the field of palliative care and related areas. Seed grant awardees will be invited to present the results of their work at the 2017 Symposium.

Palliative care provides those with a serious or chronic illness – from the time of diagnosis throughout the course of treatment – care that addresses not only physical needs but also their psychosocial, emotional and spiritual needs and optimizes quality of life by anticipating, preventing and managing suffering. It is delivered by an interdisciplinary team of physicians, nurses, social workers, chaplains, pharmacists and other practitioners. According to the Dartmouth Atlas of Health Care, more than 90 million Americans are living with serious illness today and this number is expected to significantly increase with more than 10,000 U.S. baby boomers turning 65 every day.

“To achieve the transformation necessary for palliative care to become the standard practice across the healthcare system, we need higher education faculty and researchers to engage the next generation of professionals with palliative care,” said CSU Institute for Palliative Care Executive Director Helen B. McNeal. “These seed grants will help to foster exploration, innovation and research at the nation’s colleges and universities and help to advance the work of dedicated faculty to meet this challenge.”

“Palliative care has tremendous potential for improving the quality of life for seriously ill seniors in this country,” said Tim Lash, executive vice president of strategy and successful aging for the Gary and Mary West Foundation. “The Foundation provides outcomes-based funding to support successful aging initiatives and these seed grants will advance innovative palliative care research that aligns with our mission of enabling seniors to successfully age, living life on their own terms with access to high-quality health and support services that preserve and protect their dignity, quality of life and independence.”

Five seed grants will be awarded at the symposium. Detailed information about the application process will be provided to symposium registrants upon registration. Faculty members interested in or engaged in palliative care education and research are invited to learn more about the symposium or register by visiting csupalliativecare.org/symposium. For further information, call the CSU Institute for Palliative Care at 760-750-4006.

About the CSU Institute for Palliative Care

The CSU Institute for Palliative Care is dedicated to increasing access to and awareness of palliative care by educating current and future professionals as well as community members. It offers palliative care-focused professional development and continuing education courses that are enhancing the skills of current and future healthcare professionals across the country and around the world. Housed within the largest university system in the United States, the Institute is dedicated to ensuring the trained palliative care workforce needed to meet the growing number of chronically or seriously ill people in all care settings, today and tomorrow.

About the Gary and Mary West Foundation

The Gary and Mary West Foundation is a private, 501(c)(3) non-operating foundation solely funded by Gary and Mary West and is dedicated to helping make successful aging a reality for America’s seniors. Working with grantees such as the Gary and Mary West Health Institute, Gary and Mary West Health Policy Center and other senior-focused national and community-based organizations, the Foundation’s outcomes-based philanthropy supports initiatives to advance home- and community-based healthcare delivery, services and supports that preserve and protect seniors’ dignity, quality of life and independence.

The San Diego-based Foundation is celebrating its 10-year anniversary in 2016 and accepts grant proposals by invitation only. Learn more at gmwf.org, and follow us @GMWFoundation.

CSU Institute for Palliative Care Media Contact:
Contact: Steve Dahl
sdahl@csusm.edu
(760) 750-7292

Media Contact:
Contact: Tim Ingersoll
tpingersoll@westhealth.org
(858) 412-8727

“Seniors Count!” – Rallying at the California State Capital in Support of Seniors

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Just after midnight on May 11, more than 100 seniors from across Southern California boarded buses headed to Sacramento where more than 500 older adults were gathering on the front lawn of the State Capitol building for the “Seniors Count” Rally 2016. The event, which took place during Older Americans Month, brought elected officials, community service providers and committed advocates together in support of making our state “truly the Golden State for Californians in their golden years.”

Helping to kick off the rally was Paul Downey, Serving Seniors president and CEO and chairman of the California Commission on Aging (CCoA). Downey shared the shocking statistic that fifty percent of California’s seniors lack sufficient income to pay for basic housing, food, healthcare, transportation and other basic expenses to survive in a state that has seen a significant number of devastating cuts to programs that provide critical assistance to older adults. “Our seniors have only shown us determination, fortitude and dignity in making a difference,” Downey said. “The time is now to make a change. We need to build the infrastructure that allows seniors to not only survive, but to thrive.”

A shining star of the rally was Assemblymember Cheryl Moore, current chair of the Aging and Long-Term Care Committee, who led the efforts to organize last week’s event. With over 1,000 seniors in California turning 65 every day, she stressed that it is our collective responsibility as a society to help seniors age with dignity and respect. “California’s aging population faces a diverse set of challenges, and this rally presents a forum that will allow the Legislature to work with seniors and find solutions to the issues they face.” Assemblymember Moore continued, saying that older adults in our state should not have to fight against budget cuts, see critical programs disappear and struggle to navigate a burdensome and complicated healthcare system without proper support in place. “My number one priority is to give a voice to our state’s senior community.”

State Senator Carol Liu, also chair of the Select Committee on Aging and Long-Term Care, told the crowd that now is the time for California to reinvest in its seniors. ”It’s your turn to let everyone know that seniors count,” Senator Liu said as she led the audience in a series of cheers in support of older adults. “We want dignity, to age in place and respect.”

Assemblymember David Hadley spoke of the compounding issues that surround lack of access to reliable and affordable transportation that can prevent seniors from aging in place. He stressed that our society needs to put measures in place to ensure that seniors are not forced out of their homes and communities before they are ready. One of his goals is to ensure that seniors can stay with dignity in the communities where they make their homes.

Also featured at the event was the important, yet often overlooked work of caregivers– those individuals who provide unpaid care and support to family members such as grocery shopping, transporting to doctors’ appointments and providing extensive medical care at home. Nina Weiler, associate state director for AARP and passionate advocate for older adults, pointed out that there are over 4.4 million caregivers in the state who provide care to loved ones an average of 20 hours a week without pay, which equates to $57 billion in unpaid care in California.

In total, more than ten state Assemblymen and Senators took the stage in support of three main goals: enabling aging in place, protecting vulnerable seniors and providing advocacy and information for seniors.  After the rally, attendees were encouraged to share their personal stories and experiences with aging during advocacy visits with their respective State Senators and Assemblymembers inside the Capital offices throughout the day.

“Share your stories today as only a senior can – with wisdom, courage and knowledge,” said Micheal Pope, executive director of Alzheimer’s Center of East Bay. Former California Assemblymember Mariko Yamada closed the inspiring event with an important reminder that our state is making a financial comeback, but that recovery is uneven and unfair. “Restoration and implementation of senior services needs to be a priority,” said Yamada.

At West Health and the Gary and Mary West Foundation, we couldn’t agree more. It’s why we’re committed to enabling seniors to age successfully with dignity, quality of life and independence through our applied medical research, policy and advocacy and outcomes-based philanthropy. With the U.S. in the midst of its largest demographic shift to date, the 2016 Seniors Count Rally was an important event to raise awareness in Sacramento and beyond of the need for our elected officials to take strong action to address the unique needs of seniors. As a society, we simply can’t afford not to.

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– Shelley Lyford
President and Chief Executive Officer
Gary and Mary West Foundation

Serving Seniors and Gary and Mary West Senior Wellness Center Celebrate Six-Year Anniversary

More than 100 seniors join Rep. Scott Peters and philanthropist Gary West to celebrate passage of Older Americans Act and six-year anniversary of Gary and Mary West Senior Wellness Center

Over one million meals served to seniors since 2010

More than 100 seniors gathered at the Gary and Mary West Senior Wellness Center today to celebrate the passage of the Older Americans Act (OAA) and the six-year anniversary of the Senior Wellness Center, a community-based health and wellness model of coordinated care located in San Diego that provides seniors access to daily meals and a host of holistic services and supports.

“Mary and I are very proud of the work being done here in service of seniors,” said Gary West, founder of West Health and the Gary and Mary West Foundation, which established the Senior Wellness Center.

“Our doors have been open every single day for the past six years,” West said. “With the help of our friends at Serving Seniors, we’ve served more than one million meals to our honored guests—people who have helped make this country great—and who deserve to live with dignity, quality of life and independence.”

U.S. Representative Scott Peters, a key congressional supporter of OAA, joined the festive celebration and commended Serving Seniors and the Senior Wellness Center, touting the importance of the Center not only to the seniors here locally, but as a nationwide model.

“We were really pleased to reauthorize the Older Americans Act,” said Rep. Peters. “It’s very important—it’s the foundation for the federal government support for what you do here.”

“What a resource for our community,” said Rep. Peters. “The generosity of Gary West and his wife to provide a lot of the gaps that the federal government – even when we’re working at our best – we’re not going to be able to replace the importance of the generosity of the West family.”

Featuring testimonials from regular clients, songs sung by the “West Singing Seniors,” and a ceremonial toast, the event concluded with every senior receiving a “Hope for Successful Aging” bracelet knotted in the shape of the number eight. Each one symbolizes the reality that every eight seconds someone in America turns 65, and that we should all have the ability to age on our own terms.

The six-year anniversary event was held during Older Americans Month, exemplifying this year’s theme of “Blaze a Trail,” designated by HHS to bring attention to the ways in which older adults are reinventing themselves through new work and invigorated passions, ultimately engaging their communities and positively impacting the lives of people of all ages.

The Senior Wellness Center has been blazing a trail of comprehensive health, wellness, oral and social services through its partnership with Serving Seniors since 2010.

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Lyford in Sacramento Bee: Older adults shouldn’t have to lose their teeth

The Sacramento Bee publishes an opinion submission by Shelley Lyford about the importance of the Older American’s Act and dental care for seniors. Please read the full text below.

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  • Dental health can significantly impact their overall physical and mental well-being
  • New federal law funds more oral health screenings for older adults
  • State and nonprofit agencies should do more as well

sac bee article picA dental hygienist cleans a 80-year-old Roseville resident’s teeth at her apartment. Manny Crisostomo Sacramento Bee file

By Shelley Lyford

Special to The Bee

They fought our wars, taught our children and built our roads. Yet many older Californians spend their golden years struggling to afford healthy food, a safe place to live or quality health care.

Fortunately, federal lawmakers have taken bipartisan action to help them meet these challenges.

Congress and the president just reauthorized the Older Americans Act, which provides nearly 12 million low-income seniors in California and across the country critical services, including nutrition, transportation and care-giving.

For the first time, the act also sets aside money to cover oral health screenings for seniors. This new provision is crucial, as older adults’ dental health can significantly impact their overall physical and mental well-being.

In California, the population of older adults is growing twice as fast as the general population. On average, more than 1,000 baby boomers turn 65 every day. Many of them simply cannot afford dental care.

Oral health has long been overlooked by our health care system, despite strong evidence that bad teeth and gums are linked to malnutrition, heart disease, breast cancer, cognitive decline, diabetes and stroke. Painful or absent teeth can also worsen social isolation and lead to depression.

These consequences are particularly acute for low-income seniors, who typically lack access to affordable oral care. That may force them to live in pain or lose their teeth.

Many of these problems stem from inadequate dental coverage for seniors.

Just three in 10 older Americans have private dental insurance. Fee-for-service Medicare, the largest health insurer for people 65 and older, doesn’t cover routine dental care. Dental services under Medicaid, the health program for low-income Americans, vary by state. Pressure on California’s state budget makes it difficult to provide meaningful and sustainable dental benefits through its Medi-Cal program.

By funding oral health screening for seniors, the Older Americans Act should help California begin to address the problem.

But more support and innovative, coordinated approaches are needed. The University of the Pacific’s dental school, for instance, recently launched a teledentistry initiative that sends dental hygienists into nursing homes and other underserved communities.

We’ve seen this first hand in downtown San Diego, where the Gary and Mary West Foundation will open a community dental clinic inside a popular senior center later this year. The goal is to join high-quality, affordable oral care with comprehensive health care and essential social services, including nutritious meals and mental health services.

The innovative clinic, which will have two dentists and four chairs, will also yield valuable research into the impact of providing comprehensive clinical, dental and social services for seniors. This research could help policymakers develop new models of delivering and paying for senior dental care.

The ultimate goal isn’t just to treat teeth – it’s to treat people’s health and well-being so that they can age with dignity and independence. That’s what all Americans deserve when they reach their golden years.

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Shelley Lyford is president and CEO of the Gary and Mary West Foundation. She can be contacted at Slyford@gmwf.org.

A Look Back: Six Years of Serving San Diego’s Seniors – A Celebration of the Gary and Mary West Senior Wellness Center

In 2009, our founders Gary and Mary drove through downtown San Diego and saw a line of seniors standing outside on the corner of Broadway and 9th Avenue, waiting their turn for a hot meal inside the former Senior Community Center facility.

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Only a few years before, Gary and Mary launched their Foundation to address the sad and shocking statistic that only two percent of philanthropic dollars are allocated to aging and helping seniors, a population that so desperately needs our help. The pressing needs of our nation’s seniors  resonated so deeply with Gary and Mary for many reasons, including their own difficult experience trying to navigate a complex healthcare system on behalf of their aging parents.

From that point, Gary and Mary committed to working with Paul Downey and his team to help low-income San Diego seniors receive the quality services they need to live healthy and independent lives. In 2010, the Foundation provided three million dollars to Senior Community Centers (now known as Serving Seniors) to establish the Gary and Mary West Senior Wellness Center, a state-of-the-art senior wellness center that would serve San Diego seniors who are living in or near poverty. Their shared goal was to create an inviting, easy-to-access, one-stop-shop for seniors where meals would continue to be the cornerstone, but an array of clinical, health and social services would also be offered to ensure seniors stay healthy, regardless of their ability to pay for services. Their long-term vision was for the Senior Wellness Center to serve as a national model to be shared with anyone who wanted to replicate it, and that their investment would be leveraged to become a catalyst for serving hundreds of thousands of seniors who basic human needs are not being met across this country.

Over the past six years, we have partnered closely with the Serving Seniors team to ensure that the Senior Wellness Center becomes the national model that Gary and Mary set out to create. Through one program, seniors can receive health benefits counseling to assist with navigating healthcare systems, obtain affordable care, and significantly reduce out-of-pocket medical expenses. Another program utilizes a Geriatric Care Coordinator to ensure clients understand their health conditions and care plans and empowers clients to make well-informed decisions to improve their health. The popular Cyber Café is another service which is available seven days a week to provide seniors with free computer access and assistance.

I would like to take a moment to  share a few fond memories from celebrating the Senior Wellness Center anniversaries over the years. On our third anniversary, Serving Seniors was able to shred their final mortgage statement as a symbol that all debt incurred to build the Senior Wellness Center was paid off thanks to the support of the Foundation and other generous donors. The fourth anniversary brought Mayor Faulconer and the City of San Diego to proclaim April 11 as the “Gary and Mary West Senior Wellness Center Day.” And last year, we were already well underway on our plans to build the state-of-the-art Gary and Mary West Senior Dental Center integrated within the Senior Wellness Center. Now, we are nearing the day when we can finally open the doors to provide high-quality, affordable dental care to our senior clients.

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I’m encouraged by our recent efforts to coordinate our medical and policy research with our outcomes-based philanthropy work at the Senior Wellness Center. We’re gathering health, wellness and economic data, in collaboration with the University of California, San Diego, to demonstrate the positive outcomes that community-based care coordination can have on the lives of seniors and their families.

I’m so proud of where we have come and where we are headed, together, as one team together working in partnership with Serving Seniors. The services are seamless and the seniors are better able to live with independence and dignity. Here’s to another six great years!

Cheers,

Shelley

$11.8 Million in Support from Gary and Mary West to Launch Geriatric Emergency Department

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Wests and UC San Diego Health Enhance Care for Seniors

 

SAN DIEGO, CA – May 2, 2016 – Local philanthropists Gary and Mary West have provided $11.8 million to the University of California San Diego to create a state-of-the-art senior emergency care unit to be housed within the Emergency Department at the future Jacobs Medical Center. The Gary and Mary West Senior Emergency Care Unit will enhance care for older adults and enable a multi-year medical research initiative in partnership with the West Health Institute to support their mission of making successful aging a reality for seniors in San Diego and the nation. In recognition of the West’s support, the broader Emergency Department will also be named the Gary and Mary West Emergency Department at UC San Diego Health.

Their support includes a $6.3 million philanthropic capital grant from the Gary and Mary West Foundation to create the Gary and Mary West Senior Emergency Care Unit, the first-of-its-kind in San Diego. An additional $5.5 million in planned research funding from the West Health Institute will be used to conduct multi-year medical research for developing, evaluating and disseminating innovative care approaches for geriatric patients.

“This significant combined philanthropic and research support will help UC San Diego Health fulfill its vision to offer a collaborative, interdisciplinary approach to caring for truly vulnerable members of our community,” said UC San Diego Chancellor Pradeep K. Khosla. “The Wests’ support will spur novel clinical care, research and teaching at UC San Diego, the region’s only academic health institution.”

Thanks to Gary and Mary West, UC San Diego Health in La Jolla will later this year offer enhanced emergency services designed to meet the unique needs of seniors. The services will focus on geriatric medicine, acute care screening, urgent care, case management, and social and psychiatric care. With a focus on fostering successful aging, the department will also facilitate home- and community-based care options when possible.

“Gary and Mary West share our goal of implementing new ways to enhance the quality of care and improve the overall experience of our senior patients,” said Patty Maysent, CEO, UC San Diego Health. “This future senior Emergency Department and research initiative will be the first-of-its-kind in San Diego and represent the kind of innovative, compassionate care offered throughout UC San Diego Health.”

In 2018, UC San Diego will add 8,500 sq. ft. of dedicated space for the senior emergency care unit, which will serve as a clinical, research and training hub, and become a leading site for medical education and workforce training to advance senior care.

“Mary and I are committed to helping seniors age successfully with dignity, quality of life and independence,” said Gary West, co-founder of the West Foundation and the West Health Institute. “We believe health care specifically tailored for seniors, especially geriatric emergency care, is critical to achieving these goals.”

“We are delighted to partner with UC San Diego, a leader in aging initiatives, to create an innovative environment for delivering outcomes-based senior emergency care,” said Shelley Lyford, president and chief executive officer of the West Foundation and the West Health Institute. “This model will serve as a catalyst for broader adoption of improved senior emergency care here and across the nation.”

According to the San Diego County Senior Health Report 2015, the number of local seniors aged 65 years and older is projected to double by 2030; those aged 85 years and older are projected to increase by approximately 41 percent. Last year, patients 65 and older represented 24 percent of total Emergency Department visits at UC San Diego Health.

“With more than 10,000 U.S. baby boomers turning 65 every day, seniors are one of the largest populations of patients impacting the health care system,” said Ted Chan, MD, chair of Emergency Medicine at UC San Diego School of Medicine. “We’re excited to collaborate with Gary and Mary West and the West Health Institute to engage in specialized and coordinated clinical care research, as well as provide a whole host of behavioral, urgent care and other vital programs for seniors.”

Gary and Mary West are pioneering philanthropists who established the West Foundation in 2006. To date, the Foundation has issued 367 grants totaling $162 million and created nonprofit organizations to provide outcomes-based funding to enable seniors to age on their own terms, preserving and protecting their dignity, quality of life and independence.

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About the Gary and Mary West Health Institute

The Gary and Mary West Health Institute is a 501(c)(3) medical research organization dedicated to helping seniors successfully age in place on their own terms. The Institute focuses on applied medical research and advocacy to advance home- and community-based healthcare delivery, services and supports that preserve and protect seniors’ dignity, quality of life and independence.

The San Diego-based Institute, which is solely funded by Gary and Mary West, collaborates with the Gary and Mary West Foundation and nonprofit, nonpartisan Gary and Mary West Health Policy Center in Washington D.C. on senior-centered healthcare policy and payment reform. For more information, visit westhealth.org and follow @westhealth.

About the Gary and Mary West Foundation

The Gary and Mary West Foundation is a private, 501(c)(3) non-operating foundation solely funded by Gary and Mary West and is dedicated to helping make successful aging a reality for America’s seniors. Working with grantees such as the Gary and Mary West Health Institute, Gary and Mary West Health Policy Center and other senior-focused national and community-based organizations, the Foundation’s outcomes-based philanthropy supports initiatives to advance home- and community-based healthcare delivery, services and supports that preserve and protect seniors’ dignity, quality of life and independence.

The San Diego-based Foundation is celebrating its 10-year anniversary in 2016 and accepts grant proposals by invitation only. Learn more at gmwf.org, and follow us @GMWFoundation.

Media Contacts:
Jackie Carr, 619-543-6163, jcarr@ucsd.edu
Jade Griffin, 858-822-5309, jadegriffin@ucsd.edu
Tim Ingersoll, West Health Institute, 858-412-8727, tpingersoll@westhealth.org