New Jersey Health Initiatives (NJHI) is a statewide grantmaking program of the Robert Wood Johnson Foundation (RWJF) charged with improving health care for New Jersey residents through creative, community-based health services. As of July 2009, NJHI has a portfolio of 41 active projects totaling $11,025,892.

Initially authorized in January 1987 by the RWJF Board of Trustees as the New Jersey Health Services Development Program, NJHI began with the principal objective of encouraging the development of innovative projects in ambulatory and community health care in New Jersey, RWJF's home state. The program was renamed New Jersey Health Initiatives in 1992. It has funded a variety of New Jersey community-based projects since its inception, yielding a diverse grant portfolio.

Overall Results to Date
In addition to supporting new service delivery projects or networks in a specific community, NJHI also works to see that successful concepts are replicated in other localities. Where warranted by the evidence of effectiveness, NJHI encourages implementation of health care delivery system improvements on a statewide basis With NJHI's distinct geographic focus, another core program strategy is strengthening networks of service providers.

This report highlights several current NJHI projects, and information on these active grants is available on the Web site. In addition, in-depth descriptions of a number of NJHI projects completed since 1997 are linked at the end of this report through the Project List. New projects are added periodically. They are listed in alphabetical order.

Under its first six authorizations (1987 to 2008), NJHI supported 190 projects:

• 14 under the 1987 authorization
• 29 under the 1991 authorization
• 28 under the 1994 authorization
• 24 under the 1997 authorization
• 38 under the 2001 authorization
• 45 under the 2005 authorization
• 12 to date under the 2008 authorization (as of August 2009)

Sustaining Results
To assess whether these projects funded by NJHI have been sustained after their RWJF funding, NJHI conducts a periodic online "look back" survey (2006, 2008 and 2009). Of the 116 grants that had closed out between 1990 and 2007 and had been funded for more than $100,000, staff from 69 projects responded to the survey, conducted about 12 to 18 months after the end of NJHI funding.

The 2009 "look back" survey update included responses from nine of the 11 projects that closed in 2007. It also compared these projects to those that closed in 2006, 2005 and 2004. Results included:

• Projects that closed in 2007 sustained most major types of activities from the grant period, but with some modifications, fewer clients, fewer staff members and a lower budget.
• Over the three waves of the survey, the patterns of results are similar. A majority of respondents indicated that at least some element from their NJHI projects was sustained, but there is no one path to sustainability.
• Across all the surveys, it is not surprising that securing funding was the most frequent barrier to sustainability.

Most reported several of these types of sustainability; these are not mutually exclusive types and are likely to reinforce each other. Respondents saw the major barriers to sustainability as financial—especially obtaining additional resources. Few respondents reported that internal organizational or project factors were barriers to sustainability.

Program Design
The annual responsive grantmaking program (for projects that respond to critical issues in New Jersey) is the prominent feature of the NJHI program. Over time, responsive grantmaking has evolved from supporting a broader range of projects in New Jersey that reflected RWJF's work nationally to supporting projects that were especially relevant to New Jersey and addressed specific health issues in the state. Beginning in 2008, responsive grants have focused on themes:

• Adolescent dating abuse prevention in 2008
• Health literacy among immigrants in 2009.

The program also includes several additional elements:

• A periodic pro-active or strategic grantmaking component that follows an RWJF national effort or replicates an RWJF national program in New Jersey
• A small grants program (grants less than $50,000)

Through these elements, RWJF continues to increase NJHI's influence by making meaningful grants across the breadth of the Foundation's strategic objectives and by building a cadre of skilled and informed health care leaders within the state.

Program Management
NJHI is managed by a national program office based at the Institute for Health, Health Care Policy and Aging Research of Rutgers University, located on the Rutgers campus in Camden, N.J. Calvin Bland, former chief of staff and special advisor to the president at RWJF, is the program's director, and Gretchen Hartling is the co-director. An advisory committee provides expert advice and consultation.

Funding
The RWJF Board of Trustees has authorized the program since 1987 up to a total of $72.3 million. In July 2008, the program was reauthorized at $16.8 million for 36 months—until August 2011.