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July 1, 2022 - June 30, 2023 IMPACT REPORT 2023The road to progress is full of hills and valleys. Deep-seated community health issues like infant mortality, youth mental health and health disparities are complicated, and it can take years to see change. As you’ll read in this report, bi3 is on a mission to transform health for all people in Greater Cincinnati, and beyond. •We measure impact over years and decades. For example, in 2021, Hamilton County saw its lowest infant mortality rate on record. In 2022, we saw an increase over the previous year. However, when you look at this critical work over the past decade, significant progress has been made in reducing extreme pre-term birth, the leading cause of infant death, especially for Black babies. •We invest in new programs, partnerships and policy advocacy to transform health. We cannot program our way out of our complex health issues. We must advocate for policy change to improve health outcomes. •We lead in the practice of trust-based philanthropy. We recognize the importance of leveling the power dynamic between funder and grantee and partnering in the spirit of service. We co-create new solutions to old problems by listening and engaging with those with lived experience. We seek opportunities to unite our community around a common goal. •We leverage our strategic partnership with TriHealth to drive innovation in healthcare and accelerate health equity. TriHealth is the first adult hospital system to create a Center for Health Equity, while sparking systems change by integrating and adopting new care models. The road is long, but we remain focused on leading the way to a day when every person has a fair and just opportunity to be as healthy as possible. Fiscal Year 2023 Bethesda Inc. Board of Trustees •Robert Collins, MD Chair •Denise Kuprionis, Esq. Vice Chair •Daniel Molina Secretary •Chad Reardon Treasurer •Cynthia Booth •Phillip Cox •Stuart Donovan, MD •Rance Duke •Kris Garrett •Scott Henderson •Eric Kearney, Esq. •Kathy Kelly •Christie Kuhns, Esq. •Jill Miller •Robert W. Mitchell, Jr. •Jonathan Niemeyer •Quint Studer •Melissa Thomasson, PhD •William Tsacalis •Yvonne Washington Jill Miller President & CEO, bi3 Together, we continue down the path to the day when a person’s health can no longer be predicted by race, ethnicity, ability or zip code. 1bi3’s approach to transforming health 2 T R U S T B A S E D PH I L A N T H R O P Y D I R E C T I N V E S T M E N T C O L L A B O R A T I O N A N D C O N V E N I N G R A C I A L A N D H EA L T H E Q U I T Y A D V O C A C Y E V A L U A T I O N A N D L E A R N I N G Improved Health Reduced Health Disparities Accelerating birth equity Fueling health equity and innovation at TriHealth Improving youth mental health + Our core values: Table of Contents Impact by the numbers .................................................. Accelerating birth equity ................................................ Improving youth mental health ................................... Fueling health equity & innovation at TriHealth ...... Partnerships to accelerate racial & health equity ... Building trust-based philanthropy ............................. Amplifying our work ..................................................... What’s next ..................................................................... 3 4 6 8 10 12 13 14 Levers for Change Focus Areas Respecting all people • Valuing diversity, equity and inclusion • Honoring our spiritual heritage • Building trust • Being courageousIMPACT NUMBERS BY THE $ 40 new grants awarded $13,423,923 total grant payouts 57,621 people helped by bi3 grants $ $6,838,924 bi3-funded initiatives secured in additional funding to drive impact fewer infant deaths in Hamilton County since 2013 221 2,400 youths received access to mental health support $18 Million invested in diversity, equity, inclusion & belonging development at TriHealth 41% increased investment in advocacy by halved preterm birth-related deaths of Black infants Fiscal Year 2023 3 Multi-Year Impact since 2013 to change policies to improve health” -Dr. Meredith Shockley-Smith, Executive Director, Cradle Cincinnati “ Black mothers, regardless of socioeconomic status, were three times more likely to experience infant loss than White mothers in Hamilton County in 2022. That’s why lifting up and supporting Black women’s leadership and elevating Black women’s voices became one of our cornerstone strategies. One funder that walked alongside us since the beginning is bi3. 4 Accelerating birth equity bi3 is accelerating birth equity to ensure every mother has optimal birth conditions and that racial and social disparities in outcomes are eliminated. Over the past decade, our collective work has led to significant improvements in birth outcomes, but there is still work to be done. bi3 will continue to make significant investments and advocate to improve maternal and infant health outcomes. Preterm birth is the leading cause of infant death in Hamilton County. The number of preterm birth-related deaths has declined lower than the historical average. Black preterm birth-related deaths have been nearly halved in the last decade. The Black infant mortality rate, while still too high, has improved over the last 10 years. Sleep-related deaths continue to be a major driver of infant deaths in Hamilton County. *Data provided by Cradle CincinnatiTriHealth’s OBGYN Center Fueled by a $3.7 million bi3 grant awarded in 2018 The TriHealth OBGYN Center has changed the model of care to surround moms and babies with the clinical and social supports needed for healthy births. 1,200 patients referred to Legal Aid of Cincinnati to address health-harming legal needs Cradle Cincinnati Fueled by $4.9 million in bi3 grants awarded since 2013 Cradle Cincinnati supports moms and babies in the communities experiencing the highest rates of infant mortality and centers the voices of Black women through Queens Village. Queens Village engaged Black women in events in Cincinnati and has expanded to chapters nationwide 2,200 500+ 13 Groundwork Ohio engaged 400 statewide advocates, including families, at the Big Voices for Little Kids Advocacy Day at the Ohio Statehouse to speak directly to policymakers Advocating for systems and policy change bi3’s Birth Equity Policy Priorities: •Expand income eligibility for Medicaid coverage for families and children •Create continuous coverage of children up to age 6 to reduce gaps in coverage •Advocate for Medicaid coverage of doula services, which are an evidence-based approach to improving maternal and infant health outcomes In Fiscal Year 2023, bi3’s partners Groundwork Ohio , Philanthropy Ohio , Children’s Defense Fund of Ohio and others successfully advocated for the Fiscal Year 2024-2025 Ohio state budget to include: •Continuous Medicaid coverage for children ages birth to 3 years old to ensure access to healthcare Medicaid coverage for doula services to improve birth outcomes 5Improving youth mental health 6 TriHealth Integrated Behavioral Health Fueled by a $9 million bi3 grant awarded in 2022 CHNK Behavioral Health Fueled by a $1.5 million bi3 grant awarded in 2022 TriHealth is integrating behavioral health support within primary care—with $3 million dedicated to pediatrics—to aid physicians in connecting families to the resources they need. CHNK Behavioral Health is expanding access to mental health services for youth and their families in Northern Kentucky. Served 1,260 families in Fiscal Year 2023, a 70% increase over the previous year, with a growing waitlist Expanded school-based, day treatment, outpatient and partial hospitalization services to serve more youth and families Leveraged bi3’s investment to drive more than in additional funding to expand behavioral health services $ To date, three of TriHealth’s 12 pediatric practices have integrated behavioral health resources, and all practices are leveraging psychiatric and community navigation services to connect families to care More than 1,000 referrals have been provided to families $2 million bi3 has been funding mental health efforts for the past decade, and now, we are sharpening our focus to make transformative investments to address the ongoing crisis and outcome disparities in youth mental health. We need to change our systems of care to prevent and treat these issues early. Every child deserves the opportunity to be healthy and thrive. 2,400 Nearly youth and their families have access to mental health supports fueled by bi3 ” -Parent of a TriHealth pediatric patient “ It’s such a relief to have someone helping me find resources and making sure we get in. I really like knowing we can come back in if we ever need to.Advocating for systems and policy change ” -Kinsey, 11th Grader “ I think that it’s important to recognize mental health is just as important as physical health. You are worthy, and there’s people out there that want to help you. Empowering students to improve mental wellness bi3 partnered with the Hamilton County Commission on Women and Girls to launch the region's first World Teen Mental Wellness Day. Students in 11 high schools created and led activities to reduce stigma, increase awareness and determine solutions. These student leaders played a key role in starting conversations about youth mental health. bi3 partners and others also successfully advocated for the passage of the Hamilton County mental health levy ensuring essential services continue in our community There is a lack of parity for reimbursement between physical and mental health services. Low reimbursement rates contribute to the lack of providers and long waiting lists for services. bi3 is advocating for an increase in Medicaid reimbursement for behavioral health services. In Fiscal Year 2023, bi3, its partners Ohio Children's Alliance and Mental Health and Addiction Advocacy Coalition, and others advocated for a 20% increase in reimbursement rates in the Fiscal Year 2024-2025 Ohio state budget. The budget included a 10% increase. While it is a start, it is not sufficient to support the system of care youth and families need. Jill Miller pictured with Ohio State Senator Louis W. Blessing, III 7Next >